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Conference, Counseling and
WHAT WE BELIEVE
CONFERENCES & RETREATS
PARTNER WITH US
Please fill out the following form to help us better understand your needs.
Date of Birth
What type of counseling are you intersted in?
Have you or anyone in your family ever been hospitalized for mental health reasons?
Please breifly describe why you are seeking counseling.
I declare that I am seeking mental health and/or spiritual counseling, however if I am experiecing suicidal thoughts I will immediately call the suicide prevention hotline 800-273-8255
Thanks for submitting!
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