Due to COVID-19 and to ensure that we are able to provide the best quality of care for our clients, we will not be accepting new client intakes until April 1.
Due to COVID-19 and to ensure that we are able to provide the best quality of care for our clients, we will not be accepting new client intakes until April 1.

New Client Intake Form

Personal Information

* Required fields

Select Primary Phone Type *

Select Secondary Phone Type

 

 

 

 

EMPLOYER INFORMATION

EDUCATION

GROSS HOUSEHOLD INCOME

APPOINTMENT INFORMATION

Provide information on why you are coming to counseling so that we can best meet your needs *

 

professional counseling and care for the mind, body and spirit

News
Sign up for our newsletter