Licensed Professional Counselor
Depth-Oriented Transpersonal Psychologist
Board-Certified Coach
Begin Your Intake Process
The first step is determining whether this work is an appropriate fit.
Third Realm Integration offers specialized support for non-ordinary states, spiritual emergence, transpersonal coaching, psychedelic integration, ketamine integration therapy with a licensed medical provider, and limited transpersonal psychotherapy. Because this work is focused and selective, all new inquiries begin with an intake screening.
This screening helps me understand what kind of support you are seeking, whether your needs fall within the scope of my current services, and whether a consultation or referral is the most appropriate next step.
Before You Begin
Please complete this form only if you are seeking support related to one of the services currently offered through Third Realm Integration: transpersonal coaching, psychedelic integration coaching, ketamine integration therapy (and are under the care of a licensed medical professional), or limited transpersonal psychotherapy.
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Third Realm Integration is a specialized practice, not a general mental health therapy practice. I do not provide primary treatment for anxiety, depression, relationship issues, life stress, or other standard mental health concerns. My work is focused on transpersonal integration, non-ordinary states, spiritual emergence, psychedelic/ketamine integration, existential transition, and profound inner change.
If you are experiencing a medical or mental health emergency, are at risk of harming yourself or someone else, or need immediate support, please call 911, call or text 988, go to the nearest emergency department, or contact local emergency services.
What This Screening Helps Determine
The intake screening helps determine whether your needs appear aligned with the scope of this work, whether coaching or psychotherapy may be the more appropriate service path, and whether your current location allows psychotherapy services to be provided legally.
It also helps assess readiness, safety, clinical appropriateness, and whether another provider, service, or level of care may be a better fit.
Submitting this form does not guarantee that services will be offered or that a consultation will be scheduled.
After You Submit
I personally review each submission and respond within 3 business days.
After reviewing your intake screening, I may respond with one of the following:
• an invitation to schedule a consultation
• a recommendation for a different service path
• a referral or alternative recommendation if I am not the best fit
• a recommendation for a higher or different level of care, if appropriate
Your readiness, safety, location, goals, and alignment with the current scope of services all matter in this process.
Important Note
Completing the intake screening does not establish a therapist-client or coaching-client relationship. A professional relationship begins only after fit has been assessed, services have been mutually agreed upon, required forms have been completed, and an initial session has been scheduled.
If your needs fall outside the scope of my current services, I may recommend a different provider, different service type, or higher level of care.