Waitlist Request Form

This form is for potential clients seeking to be contacted when space opens up with Krista Maness. Please fill out this form completely. Completion of this form indicates your desire to be placed on a waitlist and in no way starts or guarantees a therapeutic relationship.

I am seeking:

My availability for 60 minute sessions is:

Please check to indicate understanding of the following:(required)

Your privacy is important to me. I will never share your information.