Name * First Name Last Name Phone * (###) ### #### Email * Session Type * Individual Therapy Couples Therapy Clarifying Question * 1. Presenting Problem(s) Current Level of Stress/Distress due to Issue? (Scale 1-5 low to high) * 1 2 3 4 5 Preferred Session Type * Preferred Session Type In Person Online Either Yes, I'd love to get free tools, tips, and updates from Known Counseling * Yes No Thank you for taking the time to complete this form. Your response will greatly assist us in tailoring our approach to meet your unique needs. We will be in touch soon to discuss the next steps. If you have any immediate questions or concerns, please feel free to reach out via text to 720-257-9263 Change Begins Today!Find relief, rebuild trust, and move forward Schedule your Initial Session to Get the Support that you Need.John@known.care(720) 257-9263 Book My Own Appointment
