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If you are interested in becoming a client at TRC, please complete this form. We will contact you within 2 business days with more information via the email address you provide below. 

Client Information

Insurance & Fees 

More Information

Preferred Appointment Days
Preferred Location
Preferred Appointment Times
Preferred therapist for Mayfield Village
Type of Counseling
Preferred therapist for North Canton

Thank you for submitting the contact form. If you are seeing this message, your contact form was submitted successfully.​We will be in touch with you via the email address that you provided. If you do not hear from us within 2 business days, please check you spam folder. Any further questions, please email Dr. Rogers directly at

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