Appointment Request form for Couples

Couples, please fill out the form below.  This is the information we need to set up an account for you in the portal.

Instructions: Please Read

To request an appointment, please fill out the form below and we will set up an account for you in the online portal.  You will get an email with instructions for logging in and completing your profile and new patient paperwork.  Once everything is set up you'll get access to the calendar where you can select an appointment that works for you. 

The form is run through secure servers with SSL encryption, however, please know that there is no way to secure online forms 100%. We do everything we can on our end to protect your privacy, however, there are things that are outside of our control such as your computer. For more security, you are encouraged to use a computer that is running a quality anti-virus software and a secure browser. If you're not comfortable filling out this information online, please send a message to or you may call the office at 423-834-7209.   

If you are a current patient (you've been seen at Thrivepoint Counseling previously), please login to the secure patient portal.  You may also send an email to

If you are having a crisis or emergency please do NOT use this form.  Instead please call 911 or go to your nearest ER. 

Dr. Santan works with adults ages 21 and older. He provides individual and couples therapy. Dr. Santan can help with a wide range of life and mental health challenges and specializes in issues of anxiety (general anxiety, panic, OCD and phobias) and romantic relationships. Dr. Santan does NOT currently work with issues of trauma, abuse or PTSD. 

Secure Appointment Request Form - Couples Counseling

This form is for couples counseling appointment requests only. If you're interested in individual therapy, please click here for the individual counseling form.

*Dr. Santan works with adults ages 21 and older. He works with individuals and couples (marriage, pre-marriage).

**Dr. Santan does NOT work with issues of trauma, abuse or grief.

Thank you for placing your trust in us. We will reply within 2 business days. If you haven't heard from us within 2 business days, please be sure you can receive voice mail, check your SPAM folder or call us at 423-834-7209.

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