top of page
Reach out to
Nicole Knowlton

Please fill out the information below and Nicole Knolton will respond within 24 hours. 

Asperger's symptoms are presenting for:
ADHD symptoms are presenting for:
The type of therapy that we are interested in:
Where do you reside? (this impacts whether you are matched with a neurodiverse therapist or a neurodiverse coach).
ASD Assessment and/or Diagnosis:
Incorporate spirituality?

Information shared on this intake form may be viewed by members of the Neurodiverse Couples Counseling Center staff. 

By entering your information, you will be added to our mailing list however you will be given the option to unsubscribe at any time.  

Thanks for submitting! We will contact you within 24 hours

bottom of page