Request appointment | Beneath the Surface Therapy

Request an appointment

By which methods do you give Jillian Ellison permission to contact you about this inquiry? Select all that apply.

Select only methods you permit for responding to this inquiry and arranging possible next steps. These choices are not consent to psychotherapy or newsletter/workshop marketing. You may change your contact preferences by notifying me.

Telephone call to the number I provided. Voicemail permission is addressed separately. Email to the address I provided. Text message (SMS) to the number I provided, for administrative communication only. Do not contact me at this time. I will contact the practice directly. Select this option alone.

Are there any contact restrictions, privacy needs, or instructions you would like me to follow?

For example: the name to use when contacting you; whether to avoid the practice name; preferred calling times and your time zone; a shared phone or email account; different limits for email and text; or an accessibility need. Identify which number or address a restriction applies to if you provided more than one. You do not need to explain why you have a restriction or share a trauma history.

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For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.