Appointment Request & Registration Packet
To schedule an individual or couples session or to obtain additional information about any of the counseling services provided, please fill out the form below or 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
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We are committed to your privacy. Do not include confidential or private information regarding your health condition on this form or any other form found on this website. This form is for appointment requests only. Call the office for general questions. |
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Serving Germantown, Memphis and surrounding areas
Office Hours
8570 Cordes Circle Suite 9 Germantown, TN. 38139
Primary
Monday:
9:00 am-6:00 pm
Tuesday:
9:00 am-7:00 pm
Wednesday:
9:00 am-7:00 pm
Thursday:
9:00 am-7:00 pm
Friday:
9:00 am-6:00 pm
Saturday:
Closed
Sunday:
Closed