Healing Together

if you are a representative of an organization, corporation, agency, or group therapy practice, and want to collaborate with Healing in the Margins to provide therapeutic programming for our LGBTQIA+ and/or BIPOC community, please complete the form below.

Name

First Name

Last Name

Phone

(###)

###

####

Organization, Corporation, or Practice Affiliation

What is your role with the organization?

How did you hear about us?

Please tell us more about how you'd like to collaborate