Your First Step: Request an Intake Appointment Please complete the form below. We will be in touch. Request Appointment Name * First Name Last Name Phone (###) ### #### Email * How Can We Help? * Therapist Request * Kevin 'Casey' Cherry LPC LAC Natalie Cherry LPC Kathryn Paige Killam LCSW Myldha Verdelus MA Daniel Harpole MA FIRST AVAILABLE Communication Agreement * By Checking Yes, you agree to The Incite Center staff or office assistant replying to this inquiry and communicating with a reply to the phone number and/or email provided in this form. Yes, I AGREE POLCIES * The phone number and email provided in this form will not be shared with any third parties. For more information, please see our practice policies https://www.theincitecenter.com/sms-privacy-policies YES, I UNDERSTAND SMS Communication By checking the box, I agree to receive SMS messages about scheduling from The Incite Center staff at the above phone number. The SMS frequency may vary. Data rates may apply. Text HELP to 720-295-7304 for assistance. Reply STOP to opt out of receiving SMS messages. *Your phone number & email provided will not be shared with any third parties. YES, I CONSENT & AGREE Thank you! You should receive a response within 48-72 hours. If you need to speak with someone sooner, please call us at 720-295-7304. The Incite Center: Lone Tree LocationMain Home Office 9220 Teddy Lane, Suite 2000 A/B Lone Tree, CO 80124 The Incite Center: Englewood Location Aspire For Women OBGYN125 Inverness Drive East, Suite 210, Englewood CO 80112
