Request edit access
Joyful Journeys Counseling
Request for Counseling

Sign in to Google to save your progress. Learn more
Submitting a request form for counseling is not a guarantee of services. Currently, we have a waitlist as we work to put into place all requirements essential to continue legally and ethically serving the community with professional mental health care. Please understand that the submission of this form will add your name to our waitlist. If you are in need of immediate help or are in an emergency situation, please contact Crisis Text Line at 741741; 24-Hour Help Line at (512) 472-4357; Safe Place at (512) 267-7233; or General Emergency at 911. Thank you for your patience and continued support while we grow! *
Your Name *
Email *
Address *
Phone Number *
Date of Birth *
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy