Counselling Appointment - Existing Client
If this is your first appointment with Michelle please fill out our intake form instead: https://goo.gl/forms/ZbMp7qVROhNiDmBv1
Email address *
Name *
Your answer
Phone Number *
Your answer
Are you a QUEERFLEX member? *
What times are you available? (Michelle will email with a specific appointment time)
Please select all that apply
12-4 PM
4-8 PM
Monday
Is there anything specific on your mind?
Your answer
Have you been experiencing suicidal thoughts? *
Any other comments and/or questions?
Your answer
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