Initial Consultation Request

Your Information

First Name: *

Last Name: *

Contact Phone :*

Contact Email: *

Case Type *

Choose Date: *

Choose Time (all times are EST) *

Please let us know of any special circumstances in scheduling this appointment

About Initial Consultations

Initial meetings are held via Zoom Video conference. Upon registration we will email you login information and instructions. Please notify us at least two business days (not counting weekends and holidays) if you need to reschedule or cancel a meeting.

Payment Information

Amount Due: $150.00

Card Number *

Exp Date (mmyy) *

CVV Code *

Our office manager will call to confirm your request

Thank you!

Initial Consultation Request

Payment Information

Courses

Company

Resources