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CONTACT INFORMATION
In order to receive individual counseling you can reach us in two ways:
1) You can directly come to our center on every week day between 8.30-12.30 and 13.30-17.30 and fill in the intake form. On this day or a day later you can call us (661-2187 & 661-2188) to learn about your appointment date and time.
2) You can also fill out the intake form below and e-mail it to us and then we can e-mail you back and inform you of your appointment date and time within one day.
* Should you need to make changes in the date and/or time of your appointment, please let us know about the change at least one day before so that our program is not bogged down and we can provide you with the best service.
| To save the form to your computer please click the right button of your mouse on the picture of the form on your right hand side and pick "Save Target As..." from the menu. |
Personal Information Form
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The information you share with us by filling it in the form will be kept confidential and will not be shared with anyone but used for serving you better. Thus it is essential that you fill out the form.
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