Request An Appointment

 

Our highly trained and licensed therapists can help you gain perspective, as well as provide professional support and guidance to help you navigate through life’s challenges. When you are ready to schedule an appointment, most often we are able to schedule you with a therapist within a few days.

 

We Listen.

First Name
Last Name
Suffix
Birth Month *
Birth Year *
Country
Address Line 1
Address Line 2
City
State
Postal Code
Phone Number
ext Extension
Relationship to Client
Relationship to Client:

Select A Service

I'm interested in:


Preferred Days and Times

Preferred Day of Week
Preferred day of the week (Select all that apply)
Preferred Time of Day
Preferred time of day? (Select all that apply)

Billing Information

Is your employer an EAP (employee assistance program) partner of the Pastoral Institute
Employer Name

Click Here to see a complete list of employers who participate in our Employee Assistance Program.

Is your church a CCP (covenant congregation program) partner of the Pastoral Institute

Click Here to see a complete list of affiliated congregations who participate in our Covenant Congregation Program.


Are you interested in spiritually integrated therapy?

 

*This is a request to schedule a future appointment with a counselor.  If you are experiencing an emergency or crisis, please dial 911 immediately.  You can also reach the National Suicide Prevention Lifeline at 1-800-273-8255. 

Powered by Firespring