To schedule a FREE, 15 minute phone consultation, please complete the form below. All inquires are completely confidential. We will respond to you within 48 hours of your submission.

Due to the nature of our work, Act2Change therapists are often unable to answer inquiry calls during normal business hours. We encourage all new clients to complete the form below in order to receive the quickest response. We thank you for your interest in our practice!

**Please Note: Dr. Annisa Pirasteh is not currently accepting new clients for relationship therapy services**

Name

First Name

Last Name

Date of Birth

Pronouns

Email Address

Phone Number

(###)

###

####

Location

Message

Health Insurance and/or EAP Provider

How did you hear about us?

Dr. Annisa Pirasteh is not currently accepting new clients for couple and relationship therapy services.

I understand and am reaching out for individual therapy services.

For the safety of our clients and community we are only offering Telehealth services at this time.

I understand and agree to meeting with an Act2Change therapist virtually for the foreseeable future.

In Case of an Emergency

If you are in crisis, please call the Georgia Crisis and Access Line at 1.800.715.4225 or visit your nearest Emergency Department.

Appointment Request

Appointment Request for New Clients

In Case of an Emergency

Act2Change Therapy & Wellness Center