I look forward to meeting with you very soon. Please complete the forms, below, which I have instructed you to complete and email them back to me.

NOTE ABOUT PAYMENT: Your credit card is required prior to the time of your first session. By providing your credit card you agree to the cancellation policy whereby you will be charged for your appointment unless 24-hour notice is given.

Please submit payment here

The following forms are REQUIRED for meeting with Moses Kushaba

Telehealth Consent Form

Adult Intake Form

Or

Child Intake Form