ServingLeaders | SL Counseling -- Confidential Counseling Inquiry Form
If you have any questions, contact Angela Commiskey at
Spouse Name (for couples counseling):
Can we leave a voicemail?
Town of Residence
How did you hear about ServingLeaders | SL Counseling?
If "Other" fill in how/where below:
Preference for Counseling Location:
Willow Grove, PA
West Chester, PA
In several sentences please summarize what is prompting you to come to counseling and what you would like to focus on:
Availability during the week (please provide specific time ranges for specific days):
Preference for male or female counselor (we do our best to accommodate but cannot guarantee that your preference will be met).
Current Ministry Involvement
Do you play a leadership role in a ministry?
If involved in ministry, in what capacity?
Fee Structure & Questions/Comments
Sessions vary in cost from $120-150 depending on the experience and credentialing of the counselor.
Do you have any other questions or concerns about counseling?
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This form was created inside of ServingLeaders Ministries.