Serenity Counseling Services
Home
About
Contact
Registration Forms
Gambling Assistance
Please submit questions, comments, or to schedule your first session.
*
Indicates required field
Name
*
First
Last
Email
*
Questions/Comments
*
I prefer to be contacted by:
*
Email (Please add your preferred email for contact)
Text (Please provide cell # in space provided)
Phone (Please note phone # you would like to be reached)
Therapist does not need to contact me
Phone Number
*
Please add phone # and if you would like the therapist to call you.
Upload File
*
Max file size: 20MB
Please upload any documents including intake forms prior to your first appointment.
Submit
Home
About
Contact
Registration Forms
Gambling Assistance