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Tired Of The Way Your Life Is?

Want To Move From Surviving To Thriving?

Ready to do the Work to Get There?

If so, I’d love to talk to you about how I can support you in creating the life you want!

I offer a Free 20 minute Phone Consultation, so we can both see if we are a fit for each other.

You can schedule through my Secure Online Scheduler

or

Please fill out the form below to contact me

It's that easy. Contact me now!

    First and Last Name (required)

    Your Email (required)

    May we contact you by email? (required)

    Phone Number (required)

    May we leave a message for you at this phone number? (required)

    What type of counseling service are you requesting? (required)

    Couples CounselingIntensive Couples CounselingPremarital CounselingIndividual CounselingIntensive Individual CounselingParent Support CounselingTeen CounselingFamily CounselingEMDR TherapySomatic Experiencing TherapySand Tray TherapyGroup

    If registering for a group, please select it below:

    From Surviving to Thriving: Group for Those Experiencing Anxiety and DepressionFrom Surviving to Thriving: Group for Helping Professionals

    Partner’s Name (optional- for couples counseling)

    Partner’s Email (optional- for couples counseling)

    Partner’s Phone Number (optional- for couples counseling)

    Fee Requested
    Please select the fee based on your ability to pay and what works for your personal budget and finances. No verification of income or proof of need for sliding scale services is required.
    (Note- The first session, also known as the intake session, is 80 minutes in length for all couple and family appointments. This allows us plenty of time to discuss your needs and goals. Fees for the 80 minute intake session are: $220)

    $200 per 50 minute session$250 per 80 minute sessionGroup FeeWorkshop Fee

    Insurance
    I am an out of network provider. I can provide a receipt (called a superbill) that you may be able to submit to your insurance for out of network reimbursement. Please check with your insurance to see what your mental health coverage is.

    I need the following appointment schedule:

    Evening AppointmentWeekday AppointmentWeekend Appointment on SaturdayWeekend Appointment on Sunday

    If you need your appointment scheduled for a specific weekday, weekday evening, or time of the day on the weekend, please indicate your preference below.

    I prefer to attend appointments:
    Online (through secure client portal)In Person

    I want to address the following issues in counseling:

    Communication ConcernsConflict in RelationshipDivorce/End of RelationshipDepressionAnxietyManaging Overwhelming EmotionsTraumaAddiction/RecoverySelf-EsteemPersonal EmpowermentFinding Work-Life BalanceYoung Adults / Young Couples in 20s and 30sAdults / Couples 50+Premarital CounselingPrepare / Enrich Premarital CounselingFamily Relationship(s) / Family of Origin IssuesPerformance Concerns for AthletesInfidelity in RelationshipLGBTQ Relationship ConcernsSexual HealthSexual ConcernsMulti-cultural / Intercultural IssuesCareer or Work ConcernsGrief & LossFamily of Origin IssuesTeen CounselingExpecting/ New ParentsAdoptionParenting SupportParenting Teens with Behavioral TroublesStep parenting and Blended FamiliesDifficult ChildhoodFinancial ConcernsOther

    How did you hear about us? (Website, referral, etc.) (required)

    Is there other information you would like to provide?

    Notice regarding email communication
    This form will be submitted to Carlene Lehmann, LMFT via email message. Email is a convenient form of communication, but confidentiality of the information submitted cannot be guaranteed due to email providers storing information on their servers. It is possible that your form submission could be viewed by a third party. By submitting this form, you are acknowledging the risk, however unlikely, that may be involved in submitting this form.

    I have read the statement above regarding submission of this form and acknowledge and agree to its contents.

    If you are experiencing an emergency, please call 911 or: 

    ATX 24-HR Crisis Hotline:
    (512) 472-4357
    Shoal Creek Psychiatric Hospital:
    (512) 452-0361
    St. David’s Pavilion Psychiatric Hospital:
    (512) 867-5800
    National Domestic Violence Hotline:
    1 (800) 799-7233
    ATX 24-HR SAFEline (abuse/domestic violence):
    (512) 267-7233
    National Suicide Prevention Hotline: 
    1 (800) 273-8255
    LGBT Trevor Project Lifeline:
    1 (866) 488-7386
    National Sexual Assault Hotline:
    1 (800) 656-4673
    Crisis Text Line:
    Text “HOME” to 741741