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Intake Forms

Print and complete the appropriate intake form. Scan completed form and upload the signed form.​

If you need Adobe Acrobat, download it here.

Contact Details

Melanie Knapp, LMFT #161793

5701 Lonetree Blvd., Suite 108-D

Rocklin, CA 95765

Mekcounseling@gmail.com

Preferred Date and time
Month
Day
Year
Time
HoursMinutes
Appointment is for...
Adult(s)
Minor(s)
Couple
Family
Court Ordered
Type of Appt
In-person
Telehealth

Please do not submit any Protected Health Information (PHI).

By clicking send you agree that the phone number you provided may be used to contact you (including autodialed or pre-recorded calls). Consent is not a condition of purchase.

Appointment Requests

Invest in yourself; you are worth it! To make therapy accessible, I offer a sliding fee scale ranging from $120 to $150 per session. I can also provide a Superbill for insurance reimbursement. Let's work together towards your personal growth and well-being!

Please complete the appropriate intake form and request form below to request an appointment for services. I will contact you as soon as possible to find a mutually convenient day and time. 

Melanie Knapp Headshot
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