If you would like one-on-one counseling with one of our trained peer counselors, please print and fill out this intake form. Then, either mail to us, or drop it off at our secured drop-box to the left of our front door if we are closed.
One-on-One Peer Counseling:
We are glad you are considering taking the first step by filling out an intake form. Our Center maintains a discreet and confidential atmosphere and your anonymity is of the utmost importance. We are here to help by listening, extending encouragement, and understanding in a patient loving way. It will be our pleasure to meet with you and serve you as we traverse this road of life together as “we've been where you are.”
Possible Areas of Emotional Support: