GENDER THERAPY INQUIRY FORM

Most assessments and LETTERS OF REFERRAL can be completed in as FEW AS ONE TO THREE SESSIONS. My goal is to get out of the way of your goal as soon as possible. Complete this form for an immediate estimated number of sessions you’ll need.


To learn more about the gender services available to you, the estimated length of care, and the costs associated, complete the following information and you will receive immediate information about a typical gender counseling process with Michele O’Mara, and a follow-up email with personalized details about what you can expect based on your responses below.

YOUR INFORMATION

If you have selected one service and started to answer the questions, then changed your mind, be sure to refresh the whole page to get a clean start with a new service desired.

SUGGESTED CARE FOR YOU

Thank you for completing the information above, and allowing me to better understand your needs. Please be sure to check the accuracy of your email so I can respond to you.

Based on the information you have provided, the number of sessions you can anticpate will vary according to how quickly you find relief for your concerns. Typically, clients with your concerns will meet weekly or every other week, unless your budget prohibits this, then monthly is a good idea.

SCHEDULING SESSIONS
To schedule with me, go to omaratime.com and regsiter as a new client. Select the day, time, and type (online or in-office) of session you prefer, and then complete the related intake forms. This process is 100% paperless, and all information is stored in a confidential HIPPA approved, client portal to which you will have access.

SESSION FEES
50 minutes = $130
85 minutes = $205
120 minutes = $280

I look forward to meeting you and assisting you as you journey toward your most authentic self.

Please submit your form so I can review your information and give you a personal email response with informatoin about next steps to help you reach your goals as soon as possible.

SUGGESTED LENGTH OF CARE FOR HRT REFERRAL

Based on the provided information, IT IS REASONABLE TO EXPECT A LETTER OF REFERRAL FOR HRT IN 1-2 SESSIONS.

My role in providing a letter of referral for HRT is based on the guidelines outlined in the Standards of Care v.7. As such, I am responsible to assess that you meet the criteria for Gender Dysphoria, as well as the “readiness criterea” which essentially means that you are in a life situation that will allow you to succeed on HRT.

The typical length of care required for a referral for HRT is 1 to 3 sessions, assuming there are no unexpected circumstances or variables that would prohibit that from happening.

SCHEDULING SESSIONS
To schedule with me, go to omaratime.com and regsiter as a new client. Select the day, time, and type (online or in-office) of session you prefer, and then complete the related intake forms. This process is 100% paperless, and all information is stored in a confidential HIPPA approved, client portal to which you will have access.

SESSION FEES
50 minutes = $130
85 minutes = $205
120 minutes = $280

I look forward to meeting you and assisting you as you journey toward your most authentic self.

Please submit this form by CLICKING ON THE ORANGE BUTTON BELOW so I can review your information and give you a personal email response with informatoin about next steps to get you a letter of referral as soon, and as effeciently, as possible.

SUGGESTED LENGTH OF CARE FOR HRT REFERRAL

Based on the provided information, IT IS REASONABLE TO EXPECT A LETTER OF REFERRAL FOR HRT IN 2-3 SESSIONS.

My role in providing a letter of referral for HRT is based on the guidelines outlined in the Standards of Care v.7. As such, I am responsible to assess that you meet the criteria for Gender Dysphoria, as well as the “readiness criterea” which essentially means that you are in a life situation that will allow you to succeed on HRT.

The typical length of care required for a referral for HRT is 1 to 3 sessions, assuming there are no unexpected circumstances or variables that would prohibit that from happening.

SCHEDULING SESSIONS
To schedule with me, go to omaratime.com and regsiter as a new client. Select the day, time, and type (online or in-office) of session you prefer, and then complete the related intake forms. This process is 100% paperless, and all information is stored in a confidential HIPPA approved, client portal to which you will have access.

SESSION FEES
50 minutes = $130
85 minutes = $205
120 minutes = $280

I look forward to meeting you and assisting you as you journey toward your most authentic self.

Please submit this form by CLICKING ON THE ORANGE BUTTON BELOW so I can follow up with an email after reviewing the information you’ve provided.

GENDER COUNSELING OR COACHING WITH MICHELE

My role in providing a letter of referral for HRT is based on the guidelines outlined in the Standards of Care v.7. As such, I am responsible to assess that you meet the criteria for Gender Dysphoria, as well as the “readiness criterea” which essentially means that you are in a life situation that will allow you to succeed on HRT.

SESSIONS NEEDED
The typical length of care required for a referral for HRT is 1 to 3 sessions, assuming there are no unexpected circumstances or variables that would prohibit that from happening, and that you have selected at least the following three items above:

* I am at least 18 years old
* I have had the feeling or desire, for at least the last year, that I am, or would like to be, the other gender; and/or
* I am financially independent (I do not depend on the financial support of others for my survival - i.e. food and shelter)

SCHEDULING SESSIONS
To schedule with me, go to omaratime.com and regsiter as a new client. Select the day, time, and type (online or in-office) of session you prefer, and then complete the related intake forms. This process is 100% paperless, and all information is stored in a confidential HIPPA approved, client portal to which you will have access.

SESSION FEES
50 minutes = $130
85 minutes = $205
120 minutes = $280

I look forward to meeting you and assisting you as you journey toward your most authentic self.

Please submit this form by CLICKING ON THE ORANGE BUTTON BELOW so I can review your information and give you a personal email response with informatoin about next steps to get you a letter of referral as soon, and as effeciently, as possible.

TO QUALIFY FOR A LETTER OF REFERRAL FOR GENDER CONFIRMATION SURGERY, YOU MUST:

1. Be at least 18 years old
2. Be financially independent; and
3. Have been living full time in your authentic gender at least 6 months

GENDER CONFIRMATION SURGERY LETTER OF REFERRAL

Because you are a resident of CA, NY, MI, IA, NE or AK, these states have laws preventing me from using my Indiana license to practice in their state.

I can, however, provide you with an assessment and letter of referral for Gender Confirmation Surgery if you attend a session in person. Typically, one 85 minute session is all that is needed to achieve this goal, should you be traveling through Indianapolis, IN anytime soon.
Please submit this form by CLICKING ON THE ORANGE BUTTON BELOW and indicate in the comments section that you would like to travel to Indianapolis for your assessment, and I can review your information and give you a personal email response with informatoin about next steps to get you a letter of referral as soon, and as effeciently, as possible.

GENDER CONFIRMATION SURGERY LETTER OF REFERRAL

It is likely I can provide an assessment and referral letter to you within one 85 minute session, assuming:

1. You are willing to complete a couple of assessment forms I have available online;
2. You are able to make your first letter of referral available to me,
3. You have a surgeon identified already.
4. You are at least 18;
5. You are financially independent of others, and
6. You live in a state that recognizes my Indiana counseling license.

Please submit this form by CLICKING ON THE ORANGE BUTTON BELOW so I can review your information and give you a personal email response with informatoin about next steps to get you a letter of referral as soon, and as effeciently, as possible.

Here is your immediate informatoin about receiving a GENDER CONFIRMATION SURGERY LETTER OF REFERRAL from Michele O’Mara, PhD

It is likely I can provide an assessment and referral letter to you within one 85 minute session, assuming:

1. You are willing to complete a couple of assessment forms I have available online;
2. You have been living full-time at least 6 months; and
3. You have a surgeon identified already, and
4. You live in a state that recognizes my license.

Please submit this form by CLICKING ON THE ORANGE BUTTON BELOW so I can review your information and give you a personal email response with informatoin about next steps to get you a letter of referral as soon, and as effeciently, as possible.

Here is immediate information about getting a GENDER CONFIRMATION SURGERY LETTER OF REFERRAL

It is likely I can provide an assessment and referral letter to you within one long (85 min) or two short (50 min) sessions, assuming:

1. You are willing to complete a couple of assessment forms I have available online;
2. You have been living full-time at least 6-9 months; and
3. You have a surgeon identified already.
4. You are at least 18 years old; and,
5. You are financially independent.

Please submit this form by CLICKING ON THE ORANGE BUTTON BELOW and I will review your information and send you a personal email with how to proceed.

Here is immediate information for you regarding COUPLES COUNSELING WITH MICHELE O’MARA, PHD

As a Certified Imago Therapist, a trained Gottman Therapist, and a Clinical Sexologist, Michele brings both experience and training to her work with couples.

SESSION FREQUENCY
The number of sessions required for couples counseling varies according to the issues presented. Typically couples will meet every other week, and you are often provided homework in between sessions.

SCHEDULING SESSIONS
To schedule with me, go to omaratime.com and regsiter as a new client. Select the day, time, and type (online or in-office) of session you prefer, and then complete the related intake forms. This process is 100% paperless, and all information is stored in a confidential HIPPA approved, client portal to which you will have access.

SESSION FEES
50 minutes = $130
85 minutes = $205
120 minutes = $280

I look forward to meeting you and your partner, assisting you as you pursue a healthy, connected, and satisfying relationship.

Here is your immediate feedback, based on your interest in life coaching with me.

ABOUT LIFE COACHING
Life coaching is different than counseling. The focus is not on creating a diagnosis, rather the focus is on where you want to head with your life, and how to go about getting there. I provide both coaching and counseling services to both individuals and couples. If you are interested in clarifying your gender, getting support and you do not need diagnosis, then life coaching is definitely an option for you. ** If you need a letter of referral for HRT or Gender Confirmation Surgery, you must select counseling vs. coaching.

SCHEDULING SESSIONS
To schedule with me, go to omaratime.com and regsiter as a new client. Select the day, time, and type (online or in-office) of session you prefer, and then complete the related intake forms. This process is 100% paperless, and all information is stored in a confidential HIPPA approved, client portal to which you will have access.

SESSION FEES
50 minutes = $130
85 minutes = $205
120 minutes = $280

I look forward to meeting you and assisting you as you journey toward your most authentic self.

Please submit this form by CLICKING ON THE ORANGE BUTTON BELOW so I can review your information and give you a personal email response with informatoin about next steps to get you the care you deserve as effeciently as possible.