Blog

Default Footer

Nav #1 Nav #2 Sub-nav #1 Sub-nav #2 Nav #3 Login Logout Call to Action

Dr. Michael BartaDr. Barta's 2017 work has evolved to not only find the cause of your addiction but

About Dr. Barta Irving Najman Erin Wysong-Warren Kyle Eggemeyer Reconnection Model® Speaking Engagements 5-Day Intensive Testimonials Apply For

"*" indicates required fields

Select Service Desired*

Name*

Date of Birth*

Phone*

Email*

Can we leave a voicemail?*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Have you read Dr. Barta's book TINSA (Trauma-Induced Sexual Addiction)?*

Relationship Status*

Readiness to change*

Describe in detail your need for treatment (Ex. Type of addiction, how long, consequences from behaviors, current treatment for behaviors)*

How long have these behaviors been an issue*

Have you recently been discovered or are you in crisis because of your behaviors?*

Please rate your emotional stability*

Name of your current therapist*

Is your therapist a Certified Sex Addiction Therapist*

Describe how many alcoholic drinks do you have per day?*

What recreational drugs do you use daily?*

What are your current medications?*

Is your need for treatment related to a sexual crime? - Please Describe*

This field is for validation purposes and should be left unchanged.

*Note, Dr. Barta is unable to treat sexual offenders.