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Sign up for counseling

So you are considering receiving counseling at SVRBC… Great! In order for us to give the best counsel we can beginning with the first session, we’ll need some information from you. Complete this form and we will get back to you.

This form is confidential and the data you submit will not be shared. See our privacy policy for more information.

Family life link

Health information link

Approximately how many hours per day do you spend per day on the following activities?

Religious background link

Counseling issues link

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