Appointment Booking

Request an appointment

Choose a service and a preferred time. Requests are reviewed by our team and confirmed by phone or email — a requested time is not confirmed until you hear from us.

Please do not share clinical details here

This form is not a secure channel for confidential health information, and it is not monitored for emergencies. If you are in crisis, call 911 or call/text 988.

1. Choose a service

Individual Counseling50 minutes · $140Couples & Relationship Counseling60 minutes · $175Stress & Anxiety Support50 minutes · $140Depression & Emotional Wellness Support50 minutes · $140Online / Telehealth Counseling50 minutes · $140

2. Format

In person (Bethlehem office)Telehealth video session

3. Preferred date and time

Preferred date *

Preferred time *

4. Your contact details

Full name *

Email *

Phone *

Scheduling notes (optional)

I understand this form is not monitored for emergencies, is not a secure channel for confidential health information, and that my requested time is not confirmed until Proximatrix LLC contacts me.