Request edit access
Wait-list Intake Form
Thank you for your inquiry regarding Akoma Counseling Concepts, LLC services. . We do know when we may accept new clients at this time. Please feel free to complete the waitlist- intake form.

Please note that completing this form will allow us to enroll you in sessions with anyone from Shivonne's team (Shivonne Odom, LCPC, LPC, PMH-C, Rene Hood, LGPC, CDA,  Shamella Joy, LGSW, and our graduate student interns.  Due to the nature of the counseling we provide counseling spaces fill up fast and we cannot guarantee sessions with the clinician however we have a thoroughly trained clinical staff who work under the direct clinical supervision of Ms. Odom.  We cannot provide timelines for wait list times at this moment.  
Sign in to Google to save your progress. Learn more
Email *
Name: *
Email address *
Phone *
State of Residence (We only see clients in Maryland and DC) *
How soon are you looking to schedule your appointment?
The issue(s) I am seeking to treat in therapy (in 4 sentences or less): *
Have you been to individual therapy before?
Clear selection
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy