Contact/Request an Appointment

Please fill out the following form to contact Janet L. Sharp, M.A., LPCC-S. Fields indicated with an asterisk (*) are required.

Your submission will be sent via email to Janet L. Sharp only. Your information will never be shared with others without your specific written permission. This form, however, is not secure, so please do not provide details here as to your diagnosis or previous treatment. Janet L. Sharp will contact you to discuss this sensitive information, if applicable.

*Name:
*Phone number (area code first):
Email Address
Street, Apt.:
City:
State: Zip:
How would you like me to contact you? Phone Email

May I leave a message on your voice mail or answering machine? Yes
May I leave a message with anyone else who may answer the phone? Yes
What are the best times to call?

Would you like to request an appointment?Yes
Your questions or comments: