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Reach Out to Our Team

If you’re considering therapy for yourself or a loved one, please complete the form below. Someone from our team will be happy to connect with you and help with your next steps.

For clinical supervision or general inquiries, please complete our separate inquiry form linked here.

At Legacy Counseling Center, we want to help you and your family find the therapist and support that best fit your needs. That's why our contact form asks a few extra questions! Your answers help us better understand what you're looking for and connect you with the right therapist.

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This form is HIPAA-compliant and designed to protect your privacy.

CONTACT INFORMATION

How did you hear about Legacy Counseling Center?

HOW CAN WE SUPPORT?

What type of support are you looking for? (Select all that apply)

This form is not monitored for emergencies. If you or someone else is in immediate danger, call 911. For immediate mental health crisis support, call or text 988.

What would you, your child, or couple/family like support with? (Select all that apply) You don't need a formal diagnosis or know exactly what you're looking for to receive support.

APPOINTMENT PREFERENCES

Is there a therapist you'd prefer to work with?
How would you or your child prefer to attend therapy?
What days typically work best for appointments?
What times of day typically work best for appointments? (Appointments generally start on the hour. Example: 8:00am-8:50am) Select all that apply.

INSURANCE & PAYMENT OPTIONS

Will you be using insurance or self-pay for your sessions?
Which insurance provider do you have? (The insurance providers listed below are those we currently accept. If you don't see your insurance listed but have been informed that one of our therapists is in-network with your plan, please select "Other".

THANK YOU FOR YOUR TIME

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