Serenity & Grace Counseling

Registration Form

Please fill out this preliminary registration form. You will be contacted and provided a free consultation to determine your counseling needs. This consultation will be a time for us to gather your information and for you to be properly screened before being scheduled for a virtual live session with a professional Biblical Counselor. Thank you!

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Full Name

Phone Number

Zip Code

Gender

Age

How did you hear about us?

Need for Counseling

Summary of Concern

*By clicking submit, I agree that any information provided, including sensitive information, will be used and disclosed in accordance with Serenity & Grace Counseling’s Privacy Statement. By clicking submit, I also agree to the Policy &Terms of Service.

*Hurricane Helene Victims Offer-Terms & Conditions*

Registration Form

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