Therapist Referral Form

Please fill out this form if you have referred a client to me

Inclusive & affirming provider — [He/him pronouns]

(860) 748-5390 | shane@shanescottconsulting.com
1125 New Britain Avenue, Suite 202, West Hartford, CT 06110

If you are interested in booking a training or have any questions, please contact me using the form below, and we will get back to you.