Telehealth & Contact

Telehealth

Mindful Life Counseling provides services exclusively through telehealth.

Contact Us

Please fill out the information below; your message is a priority to us and we will make every effort to respond within 24 hours.

You may also reach us at:

info@mindfullifechicago.com
312-298-9581 (call or text)

This contact form, email, and phone/text line are intended for general inquiries. If you are experiencing an emergency, please call 911 or go to your nearest emergency room. You can also call or text 988 for immediate support.

All of our sessions are virtual and available anywhere in Illinois. If you’d like to use insurance for therapy, start by checking our insurance and fees or filtering our therapists by the plan you carry. If you would like a sense of how we work first, our approach explains it. The consultation we offer is free and takes about 15 minutes.

    First Name*

    Last Name*

    Preferred or Chosen Name (Optional)

    Pronouns (Optional)

    To support you in connecting with a culturally responsive therapist, please share your racial, ethnic, and/or cultural background (Optional)

    Email*

    Phone Number*

    How Did You Learn About Us?
    Internet SearchTherapy for Black GirlsTherapy for Black MenInclusive TherapistsPsychology TodayFamily or FriendPhysicianOther

    If 'Other', Please Specify:

    Preferred Therapist*

    Insurance*

    If 'Other' Insurance, Please Specify:

    Acknowledgment: Illinois Services*
    I acknowledge that I am seeking services while in the state of Illinois.

    Acknowledgment: Telehealth Services*
    I acknowledge that Mindful Life Counseling provides services exclusively through telehealth. I understand that all sessions will be conducted remotely, using telecommunications technology, and I consent to receiving services in this format.

    What issues are you hoping to address in therapy? (A sentence or two is plenty here — there's no need to go into diagnoses, history or medications. If you're in crisis, call or text 988.)

    What days/times work best for you?*

    Is there anything else you'd like to share?