Let’s work together Name * First Name Last Name Email * Please enter your email address. This is how Dr. Lassiter will contact you. Phone Please enter the phone number you would like Dr. Lassiter to use to contact you. (###) ### #### What services are you interested in? Individual Psychotherapy Relationship Psychotherapy Coaching Public Speaking Research Consultation Trainings/Workshops Mental Health Expert Consultation for Film/TV/Arts Other Preferred Date of Consultation Please allow at least 48 hours for Dr. Lassiter to contact you. MM DD YYYY How did you hear about us? Website Psychology Today or another Therapist Directory Social Media Public Event Other Message (Optional) Please briefly describe how Dr. Lassiter may help you. I understand that Dr. Lassiter does not accept insurance but will provide a superbill for out-of-network services. His fees are $250 per 50-minute session for individual psychotherapy and coaching. Couples therapy is $300 per 65-minute session. * Yes Does not apply. I am not interested in therapy or coaching. Thank you! Dr. Lassiter will contact you shortly.