Psychotherapy and Counseling | North Palm Beach, FL

Debra Joy Goldman, MS, LMHC
Request An Appointment
North Palm Beach, FL

How to request an appointment:

Select at least 3 possible days/times that would work for you.
(Some appointments are already booked, so not all times displayed are available.)
I will review my schedule and find an appointment time which matches your request
I will confirm your appointment by phone and/or email within 24 hours (usually much sooner)

PLEASE NOTE:
6:30 p.m. appointments are occasionally available on Tuesdays and Thursdays.
If you require a 6:30 p.m. time please indicate this in the comments area.

All form fields with stars ("*") are required.

Day *POSSIBLE APPOINTMENT TIMES

Monday 9:00
10:00
11:00
12:00
1:00
2:00
3:00

Tuesday 9:00
10:00
11:00
12:00
1:00
2:00
3:00
4:00
5:00
6:00

Wednesday 9:00
10:00
11:00
12:00
1:00
2:00
3:00
4:00
5:00

Thursday 9:00
10:00
11:00
12:00
1:00
2:00
3:00
4:00
5:00
6:00

Friday -= CLOSED =-

*When would you like to come in for your first session?
This week or as soon as possible
Next week

*What kind of service are you seeking?
Individual (In my office)
Group
Other (Explain Below)

*First Name:

*Last Name:

*What is your age?

*What is your gender?
Male Female

*Zip Code:

*Best number to reach you:

2nd best number to reach you:

*E-Mail:

*In the space below describe the
reason you are seeking my services:

I will carefully review your request to determine the appropriateness of my services for your needs.
By submitting this form you grant me permission to contact you by phone and/or e-mail. This form is not for use in emergency situations.