Contact Stephanie George, LISW - Online Therapist for Adults in Columbus & across Ohio

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First Name

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I understand that this form is for informational purposes only, is not HIPAA compliant, and that I am not to include sensitive or confidential information, including personal health information. *

I understand.

I understand that submitting this form or scheduling a consultation does not establish a therapeutic relationship with Aligning With Self, LLC or Stephanie L. George, LISW. *

I understand.

I understand this form is not monitored for urgent concerns or emergencies and I am to contact crisis resources as needed. *

If you’re experiencing a life-threatening mental health or addiction emergency, call 911 or visit the nearest emergency room. In Ohio, for non-life-threatening mental health or addiction crises, call or text 988 to reach the Suicide & Crisis Lifeline at https://988lifeline.org/

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I understand that online communication—particularly email and web forms—may not be fully secure and I understand the risk of using this form. *

I understand.

I consent to be contacted in response to my inquiry via the email or phone I provided above. I understand that responses are typically made by email, and phone may be used as a backup method if needed. *

I consent to be contacted.

Thank you for reaching out.