Request an Appointment for LDS Counseling
Fill out the below questionnaire to see if we have a therapist available who can meet your needs. We are currently offering clients their choice of in-person or telehealth sessions or a combination of both.
DateTime
Who are you seeking an appointment for? (Mark all that apply)
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Myself
My Spouse/Significant Other
My child(ren)
Mark the type of therapy you are looking for. (Mark all that apply)
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Individual Counseling
Couples/Marriage Counseling
Family Counseling
Group Counseling
What kind of group would you be interested in attending?
List all individuals you are seeking therapy for
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Help Us Find the Right Therapist for You
Therapist Preference
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First Available
I have a specific therapist I was hoping for
Below is a list of therapists at our office who can provide can provide counseling based on the values and beliefs of The Church of Jesus Christ of Latter-Day Saints upon request. Note: If you select a therapist with a waitlist, we will add your name to their waitlist and contact you when they have an opening available.
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James Lehnardt, PLPC, Works with ages 16+, Individual, Couples, & Family, OFFERS REDUCED RATE, CURRENTLY HAS ESTIMATED WAITLST OF LESS THAN 1
Norman Haney, LCSW, Works with ages 12+, Individual, Couples & Family, CURRENTLY HAS ESTIMATED WAITLIST OF ABOUT 2-3 MONTHS
Jeanneen Morris, LPC, Works with ages 14+, Individual, Couples, & Family, CURRENTLY HAS ESTIMATED WAITLIST OF ABOUT 1-3 MONTHS
Wendy Dyck, LCSW, Works with ages 18+, Individual Counseling, CURRENTLY HAS ESTIMATED WAITLIST OF ABOUT A 2-3 MONTHS
Seth Haney, LPC, Works with ages 7+, Individual & Family, CURRENTLY HAS ESTIMATED WAITLIST OF ABOUT 8+ MONTHS
Do you have specific criteria you are looking for in a therapist?
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Yes
No
List anything specific you were hoping for in a therapist.
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To ensure a therapist that will best meet your needs, please mark your appropriate age range.
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18-21 years old
22-29 years old
30-64 years old
65+
Client's Gender
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Male
Female
Other
To ensure we have a therapist who is able to work with your presenting issue, please briefly describe your reason for coming in.
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Schedule
Schedules vary depending on the therapist. Our evening and weekend appointments fill up quickly and may not be available for scheduling.
Select ALL days/times you could make work with your schedule.
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I am flexible and can make any time work
Mon mornings 10 am-12 pm
Mon afternoons 1 pm-4 pm
Mon evenings 5 pm-8 pm
Tues mornings 8am-12 pm
Tues afternoons 1 pm-4 pm
Tues evenings 5 pm-8 pm
Wed mornings 8 am-12 pm
Wed afternoons 1pm-4pm
Wed evenings 5 pm-8 pm
Thur mornings 10 am-12 pm
Thur afternoons 1 pm - 4 pm
Thur evenings 5 pm - 8 pm
Fri mornings 8 am - 12 pm
Fri afternoons 1 pm - 4 pm
Fri evenings 5 pm
Sat morning 8 am-12 pm
Sat afternoon 1 pm - 4 pm
How did you hear about us?
*
Be specific, for instance if a friend referred you, please write your friend's name.
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Contact Information
If we have a therapist available that meets your needs, we will email you some paperwork so we can finish setting up an appointment. Each individual attending therapy will need their own set of paperwork completed.
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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Area Code
Phone Number
Person filling out this form's Name
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First Name
Last Name
Person filling out this form's Email
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example@example.com
Person filling out this form's Phone Number
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Area Code
Phone Number
Spouse/Significant Other’s Name
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First Name
Last Name
Spouse’s/Significant Other’s Email
example@example.com
Spouse/Significant Other's Phone Number
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Area Code
Phone Number
Each family chart is set up under one client name. For family sessions, which family member would you like the chart to be set up under.
First Name
Last Name
Submit
Should be Empty: