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Appointment Request

To schedule an individual, children, couples, marriage or family therapy appointment or to obtain additional information about any of these counseling services, please fill out the form below or give me a call. 

This form will be submitted to the office of Ji Young Kim, MA, LPC via email message. Email is a convenient form of communication, but confidentiality of the information submitted cannot be guaranteed due to email providers storing information on their servers. It is possible that your form submission could be viewed by a third party. By submitting this form, you are acknowledging the risk, however unlikely, that may be involved in submitting this form.

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.

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By clicking send you agree that the phone number you provided may be used to contact you (including autodialed or pre-recorded calls). Consent is not a condition of purchase.