Reach out today.

Take the first step toward creating the life you truly want. Schedule a free 15-minute consultation with me— You can share a bit about why you are seeking therapy, I’ll answer your questions and tell you how I can help you reach your goals, and you can decide if I’m the right therapist for you.

Information about which insurance I am able to accept and fees is in my FAQs.

Name

First Name

Last Name

Email

Phone

(###)

###

####

How do you prefer to be contacted to schedule our consultation? (If requesting email contact, please check your spam folder. I typically reply within 1 day).

In which state are you located?

I am only able to provide therapy to someone who is physically located in a state in which I am licensed: AL, AZ, AR, CO, CNMI, CT, DE, DC, FL, GA, ID, IL, IN, KS, KY, ME, MD, MI, MN, MO, MS, NE, NV, NH, NJ, NC, ND, OH, OK, OR, PA, RI, SC, TN, TX, UT, VA, WA, WV, WI, and WY.

Is there anything you'd like to share with me prior to our conversation?

Note: Please do not include Personal Health Information in this form.

If requesting phone contact, do you give permission for me to leave a message?

Yes

No

jen@jennifermieschphd.com
208.254.1694

If you are in crisis, are having thoughts of suicide, self harm, or harming someone else, do not use this form. I do not provide crisis services. If you are in imminent danger, call 911 or go to your nearest emergency room.

If you need mental health support, call or text the Suicide and Crisis Lifeline at 988.

Thank you! I look forward to hearing from you.

Reach out today.

Jennifer Miesch, Ph.D.

Compassionate online therapy for insightful adults in 43 states and territories