Consultation Form

* required field

* Name


* Email


* Confirm Email


* How Heard


It is recommended you enter your phone number.  At times people enter their email incorrectly twice, so a phone number ensures you will be contacted.


  Phone number


  Best times to contact you






  Comments or questions















Counseling for Success
Kiomi Mount, LICSW, DCSW
Complimentary Consultation

Thank you for your interest. 

Counseling for Success can help you achieve the lasting results you desire.

A complimentary telephone consultation is available so you can ask real questions in real time, and receive valuable answers that apply specifically to your life and personal needs. 

To schedule your private, 20 minute telephone consultation, please complete the form below or call (206) 355-5776.  

All information is kept strictly confidential.

© 2003- 2008, Counseling for Success, Inc.  All Rights Reserved.                            .