By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking “Yes, I want to submit this form” you agree to hold Julia Schafer harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.

Please Note: I do not check emails over the weekends or after 7:00PM during Monday-Friday. If you are having a life-threatening mental health emergency, please contact 9-1-1 or go to your local emergency room.

Colorado Crisis Services: Call 1-844-493-8255 or text ‘TALK’ to 38255.