Contact & New Client Intake

Reach out directly, or complete the intake form below to request a consultation. I'll respond within 1–2 business days.

Contact Info

The quickest way to reach me directly, before or instead of the form.

Phone Number

(248) 712-3398

Email Address

dkanso@transformationalchoices.com

Response Time

1–2 business days

If you're experiencing a mental health crisis or emergency, please call or text 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room. This form is not monitored 24/7 and is not for urgent situations.

New Client Intake Form

This form is a starting point to help me understand your needs before our first conversation — it is not a binding agreement and does not begin treatment. Fields marked * are required.

Client Information
If under 18, a guardian section will appear below.
Reason for Seeking Therapy
Insurance & Scheduling

Thank you — your intake form has been received.

Dina will be in touch within 1–2 business days to schedule your consultation. If your need is urgent, please call (248) 712-3398 or, for a crisis, call or text 988.