Appointment Request

Thank you for contacting Karina von Middendorf, PhD., LMFT. 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.