Jodi Kapicki

Your Name*

Your Email Address*

Your Phone Number

Your Message*

Hidden

Recipient Name

Hidden

Recipient Email Address

Please be aware that email is not a secure means of communication and spam filters may prevent your email from reaching the therapist. We recommend you follow up with a phone call. Sending an email using this page does not guarantee that the recipient will receive, read, or respond to your email.

If this is an emergency do not use this form. Call 911 or your nearest hospital.

CAPTCHA

Phone

This field is for validation purposes and should be left unchanged.

Jodi Kapicki

Jodi Kapicki

Find an EMDR Therapist