Energize Colorado Therapy Connection Request Form (FREE Coaching/Therapy!)
PLEASE NOTE: As of November 6th, this form has been updated, and responses are no longer being monitored. You can now make your request using the following page:
Energize Colorado is a nonprofit mobilizing generous Coloradans to provide resources and relief to small businesses, nonprofits, and individuals, supporting them in recovering from the impact of COVID-19. We've brought together mental health professionals to offer free therapy, in an effort to make sure that anyone who needs support is able to access it.
If you are in need of free therapy, please fill out the form below. Once you submit the form, we'll be in touch to connect you with one of our mental health partners. You can expect a reply from our team of volunteers within 2-3 business days.
If you have an urgent need or are in extreme emotional distress or thinking of ending your own life, please call 911 or contact the National Suicide Prevention Lifeline either by calling 1-800-273-8255 or through their online chat or contact the Crisis Text Line by texting HOME to 741741
This form should take roughly 10 minutes (or less) to complete. Thank you!
Sign in to Google
to save your progress.
PLEASE NOTE: As of November 6th, this form has been updated, and responses are no longer being monitored. You can now make your request using the following page: https://energize-colorado.typeform.com/to/FhC0R0fL
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service