Serenity Counseling Services
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Registration Forms
Please submit questions, comments, or to schedule your first session.
Name
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First
Last
Email
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Questions/Comments
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I prefer to be contacted by:
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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
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Max file size: 20MB
Please upload any documents including intake forms prior to your first appointment.
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Home
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Registration Forms