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I am honored and also excited to learn more about your commitments towards yourself and your work - along with the areas you are seeking professional support.

Kindly fill out the one of my inquiry forms below to get started and I will be in touch with you soon.

Potentia Therapy is inspired by a vision to provide specialized, collaborative, and highly personalized outpatient care. I treat the whole person and the whole spectrum of mental health issues.

Kindly note that while your phone call is very important to me, you will likely get a quicker response by filling out my contact form below. If that is not an option, please know that I will still get back to you as soon as possible.

Mailing Address:
(Seeing 100% Telehealth at this time but am receiving business mail here…)
1180 Rosecrans St #516 San Diego, CA 92106

Phone: 619.819.0283

Email: rebecca@potentiatherapy.com

START YOUR INQUIRY PROCESS FOR THERAPY:

When completing your therapy inquiry form, please make sure to complete all the questions in order for your request to be accepted. If you have any problems with this inquiry form, please email info@potentiatherapy.com and you will receive a follow-up email.

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professional consultations form

When completing your consultation inquiry form, please make sure to check which type of consultation you are seeking and also make sure to complete all the questions in order for your consultation request to be accepted. If you have any problems with this inquiry form, please email info@potentiatherapy.com and you will receive a follow-up email soon.

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In the case that Rebecca is unavailable, she will put you in touch with someone from her extensive referral network. Do you have a gender preference?

If you live outside of San Diego, what city in California do you live in? Note: I am only licensed to see those who live within the State of California.

If you live in San Diego, what part of town do you live in?

What kind of insurance do you have, HMO or PPO? Note: I am an out-of-network provider and can offer a super bill for those who have PPO insurance so you can get reimbursed directly from your insurance company. For your own planning purposes (I don't need this information) you will want to find out your deductible, how much has been met, and what percentage of the fee they generally cover. Please share any additional insurance questions you have below.

Where in your life and and work do you feel overwhelmed, out of alignment, or like you are hitting a wall? Please be as detailed as possible and add any areas of focus you are particularly motivated to focus on in our work together.

What are the best days and times for you to meet for therapy?

Phone Number

Email Address

Your Name

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ANYTHING ELSE YOU WANT TO ADD? QUESTIONS? REFLECTIONS?

HOW DO YOU SEE THIS CONSULTATION WORK SUPPORTING YOU AND YOUR BUSINESS?

WHY ARE YOU SEEKING CONSULTATIONS AT THIS TIME?

WHAT IS THE MOST PRESSING ISSUE OR AREA OF FOCUS THAT IS A PRIORITY FOR YOU IN OUR WORK TOGETHER?

SHARE A LITTLE BIT ABOUT YOUR WORK, YOUR GOALS, AND HOW YOU SEE THESE CONSULTATIONS WITH REBECCA WILL SUPPORT THESE GOALS.

EMAIL ADDRESS

YOUR NAME

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If you are outside of California and are interested in Trauma-Informed Leadership coaching, you can book a connection call

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