To request a free 15 minute phone consultation and be matched with the best provider, please submit the form below. 

We will reach out as soon as possible.

If you have any issues completing this form please call 561-288-0472 or Email info@ashleywaknine.com

Terms & Conditions

EVERYTHING IN YOUR CONSULT IS CONFIDENTIAL WITH THE EXCEPTION OF A REPORTED INTENT TO HARM SELF, ANOTHER, OR IF WE BECOME AWARE THAT A CHILD/ELDER/DEPENDENT IS POSSIBLY BEING HARMED. CHECK TO SIGNIFY UNDERSTANDING.

I understand that Ashley Waknine Counseling & Coaching is an out-of-network provider, but I can request a Superbill from my clinician to submit to my insurance company for possible reimbursement.