(214)367-0911

Contact & Screening

I'm So Happy You're Considering Meeting Me!

I will need some information from you to ensure safety & comfort for us both.

You can choose from either of the verification methods below.

 

*P411 Member Verification

*Provider Reference Verification

*Employment Verification

 

PLEASE SEE "ETIQUTTE" PAGE For More Details

It has all the information is needed for each form of

verification.

 

Privacy & Discretion Is MOST Important

I Always Observe The Utmost Discretion For The Both Of US!

 

Please Fill Out The Screening Form Below

Lets Get You Verified, That Way We Can Meet!

* Required Field
About You
Your Contact Information
Appointment Request Details
Your Reference Information
Other Screening Information
Answer this question to prove you're human: