Appointment Request & Registration Packet

To schedule an individual or couples session or to obtain additional information about any of the counseling services provided, please call the office.

Please download the registration packet below and bring completed to your first appointment. You will need pages 1-8 signed for your appointment; pages 9-12 are yours to keep.

DO NOT PRINT FROM A CELLULAR DEVICE-PRINT ONLY FROM A COMPUTER

FOR PAGE ALIGNMENT--THANK YOU  

vpcc-vpcc-registration.docx