Appointment Inquiry Form

Name

First Name

Last Name

Date of Birth

Email Address

Phone

(###)

###

####

How did you discover my practice?

Please briefly describe your career coaching needs:

Service Requested

Initial Consultation

Highlands Ability Battery

Don't Waste Your Talent Coaching Program

Please indicate days and times you would be available to meet:

(Note: my available hours are M-F 8-5)

Please use this space to provide any additional information you feel is relevant:

Phone: 404.513.6077
Email: johnrlucy@decaturpsychology.com
Secure Email is available through the client portal
Fax: 404.478.6823

Please note that I am currently conducting all appointments through online video conference.

I am located in Decatur, 101 Birch Street. My waiting room and office are on the ground floor, side entrance located on Forkner Drive directly across from the end of Glendale Avenue, of a modern townhouse. Birch Street is a new development. Birch Street is off Forkner Drive, which runs between Church Street approximately one mile north of the Decatur Marta Station and Sycamore Drive just south of Dekalb Medical Center. Please use the side entrance and not the front door. Street parking is available on Glendale Avenue, please do not park in the driveway.