Thank you for contacting Karina von Middendorf, PhD., CSAT. To request an appointment please fill in the form below with your preferred date and time. Then go to the "Helpful Forms" page and download and fully complete the Patient Financial Form. Return the completed form to the email or fax indicated on the form. Once your information is verified, you will receive an email confirmation with the available appointment time to be scheduled. 
 

We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.

Please don't put anything here: Your Name:

Your Phone Number:

Your Email Address:

Preferred Date and Time:

Your Message:

Please enter the words below: What is this? The question is meant to test whether or not you're a real human visitor, and to prevent automated spam messages. Please enter the words to submit your message. Close

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.