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Appointment Requests

Invest in yourself, you are worth it! To keep therapy affordable, I offer a sliding fee scale range of $120 to $150 per session. I can provide a Superbill for reimbursement of services to present to your insurance.

Please complete the appropriate intake form and request form below to request an appointment for services. I will contact you as soon as possible to find a mutually convenient day and time. 

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Intake Forms

Print and complete the appropriate intake form. Scan completed form and upload the signed form.

To e-fill & sign, you need Adobe Acrobat. Download here:

If you are unable to complete the form(s) online, bring the completed form(s) to your appointment.

Contact Details

Darla Gale Counseling

LMFT #92413

6135 King Road, Suite D
Loomis, CA 95650

916-741-3681

therapy@kimberlymft.com

Preferred Date and time
Month
Day
Year
Time
HoursMinutes
Appointment is for...
Adult(s)
Minor(s)
Couple
Family
Court Ordered
Services Requesting
Office Sessions
Telehealth Sessions

Please do not submit any Protected Health Information (PHI).

By clicking send you agree that the phone number you provided may be used to contact you (including autodialed or pre-recorded calls). Consent is not a condition of purchase.

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Information provided by Kimberly Goehring Therapy

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Therapy is a gift.
It is a chance to finally be heard, understood, and
supported.

-Bessel Van Der Kolk

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