When you are ready to make an appointment to start working toward a better version of yourself, please submit the form below. If you still have some more questions, please click on this link to schedule a 15-minute complimentary/free-of-charge consultation. 

NOTE: Please call 911 if you have an emergency. The form is for scheduling an appointment only, not for any emergencies. 


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Are you at least 18 years old?
Client's Name
Client's Address
Preferred Contact Method
How would you like to receive services?
Are you interested in joining an 8-week ADHD working memory training program
Please provide a few times you are available for coaching, therapy, and/or ADHD working memory training evaluation
Would you like to receive our news or blogs via email?
We are a private pay counseling practice so fees are paid in full at the time of service. Payment is accepted in the form of cash, Zelle, credit card (Visa & MasterCard) or via Paypal and Stripe. As a healthcare provider, we accept Health Savings Account (HSA) and Flexible Spending Account (FSA). The fee rates are for a licensed clinical psychologist and/or board-certified executive coach. Initial Intake Session or Treatment Planning therapy or coaching sessions (53-60 min): $299. Individual, Couple, Family Therapy or coaching sessions (45 mins): $275. Therapy or Coaching: 30 mins: $200. PLEASE NOTE: ONLY THERAPY CAN USE PPO HEALTH INSURANCE PLANS. THE ADHD WORKING MEMORY TRAINING, CAREER ASSESSMENTS, & COACHING CANNOT use PPO health insurance benefits.
I consent to Southern California Family Wellness clinicians and/or office staff communicating with me via email or text message. Click "YES" below to consent before submitting the form. Please click the "SUBMIT" button below only once and wait for a few seconds for the form to load. Of course, you can call: 949-866-3392 to make an appointment if you do not want to submit the form to make an appointment. Once you became a patient/client, we can send messages and have the telehealth session via the HIPPA-compliant confidential platform.