Counseling Request Form

counseling form

Thank you for reaching out to the Crosspoint Community Church Counseling Center.

We appreciate you taking these initial steps to connect with one of our counselors. Our counseling services are provided on an outpatient basis and by appointment only.

We operate on a direct-pay system and do not accept insurance toward the cost of session fees. To get connected with one of our counselors, please fill out the following brief form. Once you submit the form, you will receive an email reply with additional information regarding our counseling center. Please check both your email inbox and Spam/Junk mail for our email response.

If you are experiencing a life-threatening event, please call 9-1-1 or 9-8-8 for immediate mental health help.

Please Note:

Counselors at Crosspoint Community Church Counseling Center do not provide court-related services (such as, but not limited to, testifying in divorce and custody disputes, injuries, lawsuits, etc.). The goals of legal proceedings do not align with the goals of a professional counseling relationship. By requesting counseling at Crosspoint Community Church Counseling Center, you agree that neither you nor your attorney, nor anyone else acting on your behalf, will call on your counselor to testify in court or any other proceeding, nor will a disclosure of counseling records be requested for legal proceedings.