Counselee Intake Form

Welcome to RRCC! I’m glad you’re here and look forward to learning about you and your interest in biblical counseling.

Important: prior to completing this form, I encourage you to become familiar with the RRCC counseling policies and procedures forms available on the Services page of the website.

Submitting this form is the most efficient way to indicate your desire for counseling and enables me to respond to your needs more effectively. It does not create a contract to provide counseling services. Please respond to each question with as much detail as possible so I understand your reason for seeking counseling.