Schedule an Appointment

Limited time offer: I am offering 50% off your first session - just $75.

Please use this form check my availability and schedule an appointment. My fee is $150 per 50 minute session. You will receive directions to my office and a link to the initial paperwork on the confirmation page.

If you have questions or prefer to book by phone, please call me at (949) 288-3123.

Appointment Time

Date & Time:
Choose an available time... _______________________ Mon, Feb 6, 2012 -> 4 PM Mon, Feb 6, 2012 -> 5 PM _______________________ Sat, Feb 11, 2012 -> 2 PM _______________________ Mon, Feb 13, 2012 -> 1 PM Mon, Feb 13, 2012 -> 2 PM Mon, Feb 13, 2012 -> 5 PM

Don't see a time that works for you?
Add your name to my wait list.

About You

Name(s):


Telephone Number:

May I leave a message if you are not available?

Email Address to Send Confirmation:


In a sentence or two, please briefly describe your reason for coming in:

Terms

Terms and Conditions:
In case of emergency, please call 911 or go to your nearest hospital emergency room. Scheduling a first appointment does not create a "therapeutic relationship" between Mark Pines and yourself.
I understand and agree to these terms and conditions

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2007-2011