Let’s Connect

To request an appointment, please complete the inquiry form below.
If you would prefer to call, feel free to reach out to the Intake Department at:
(815) 806-9300 ext. 113.

Name

First Name

Last Name

Phone

(###)

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Email

What are you looking for?

Individual (For Myself)

Individual (For a Family Member)

Couples

Family

Appointment Preference:

Please select your appointment style preference

Availability

Please provide the dates and times you would be available for appointment

Insurance

Please provide the following insurance information here, unless you intend to self-pay: ID # Group # Name of Carrier

Is there anything else you would like us to know?

We are located at:
20855 South LaGrange Road
Suite 202
Frankfort, IL 60423

Let’s Connect

Personal Solutions Counseling, PC