I look forward to talking with you

**I’m committed to your privacy. Do not include confidential or private information regarding your health status or conditions on this form. This form is for general information, questions, or messages to Susan.

Susan Martin, MA, AMFT
Registered Associate Marriage and Family Therapist #110172

Phone/Text: (916) 287-3695

Email: susanmartin@hope-counselingcenter.org

I am a Registered Associate Marriage and Family Therapist at HOPE Counseling Center under the supervision of licensed clinicians.

Folsom:
530 Plaza Drive, Suite 130
Folsom, CA  95630

Roseville:
1528 Eureka Road, Suite 101
Roseville, CA  95661

Telehealth:
I meet with clients either in the office or, when appropriate, via telehealth using a HIPPA secure online video service.