516-764-2526
Marriage and Family Therapists of
New York
Payment is required in advance of consultation.
To  Start
Before arranging a
consultation, please send
an E-mail to
jatwood@optonline.net
stating that you would
like to begin online
therapy.
Your Name

Your E-Mail Address where we will reply to you

Your Phone Number in case we need to contact you
directly

Background Information to include:

Date of birth
Marital status and number of children with age
Brief description of the issue you wish to discuss
What you hope to gain as a result of our “talks?”
What you have tried thus far to solve this issue?
What else should I know about you?
Please do NOT send us any information about your
situation until arrangements have been made with your
consultant-therapist. We will try to respond to you within 24
hours. This response time might be slightly longer over
weekends.
To make a payment, please click on the Make A Payment
button below. The payment form will open up in a new
window. Enter your name as it appears on your card, along
with your billing address.









Complete the payment form,
including your payment amount
plus the 5% service charge
and click on the submit button.

Now we are ready to talk…
For more information call or E-Mail us at
jatwood@optonline.net
Begin Online Therapy
Information To Include
In addition, include the following information in your
initial message:
Marriage and Family
Therapy of New York
542 Lakeview Avenue, Rockville Centre, NY 11570                      19 West 34th Street, New York, NY                                         62 Storry Hill Rd., Kerhonkson, NY 12446

© 2007 Online Therapy                                                                                                                                                                                          Site By: Joan D. Atwood
516-764-2526