Request for Counseling

Thank you for filling out this form. One of our pastors or counselors will be in touch with you shortly and we look forward to meeting with you very soon.

Thank you for reaching out to CrossPoint. The process for receiving Biblical counseling is as follows:
Step 1) Fill out this form (Request for Counseling)
Step 2) Fill out the intake form (Counseling Intake Form).
Step 3) An individual from our team will reach out with a phone call to schedule your first appointment.

Name

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Email

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This address will receive a confirmation email

Phone

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Address

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How did you hear about us? Did anyone refer you?

Do you understand that the counseling you receive at CrossPoint will be based on the counselor's understanding of the Bible?

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Please select one option.

yes no

What is the main problem as you see it? (What prompted you to seek counseling)

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What days and times would work for counseling (please click all that apply)

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Please select all that apply.

Tuesday 4-5 PM Tuesday 5-6 PM Tuesday 6-7 PM Wednesday 9 AM Wednesday 10 AM Wednesday 11 AM Friday 8 AM Friday 9 AM Friday 10 AM

Description

Thank you for filling out this form. One of our pastors or counselors will be in touch with you shortly and we look forward to meeting with you very soon.

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