Your Goals for Counseling
Name: First and Last*
Preferred days/times for appointment
Briefly, what would you like to work on during therapy?
Which clinician would you like to respond to your appointment request?
Clinician profiles can be reviewed on our website (CBHealth.net)
Cheryl Hughes, LCSW, CSW-G
Kim Hiott, LPC
Sareena Miduski, LPC
Natasha Ramsey PsyD, LPC, NCC, CCTP
Cathy Sutton, LCSW
Jon Hester, LCSW