Private Counselor Form

In addition to offering free or reduced rate subscriptions to .edu related counselors, HopeCheck.org offers FREE 30-day trial subscriptions to private counselors. No credit card is needed to start your free trial subscription. After your free 30-day free trial, you can continue your subscription at a rate of $50 per month.

To start your free trial, read and accept our terms of service below. Then register your details.

After you hit "submit" on the next page you will receive an email with your own HopeCheck virtual text number. That's all you need. You can instantly begin using HopeCheck by inviting your patients or clients to text in the word "join" to start. You have 30-days to use the service free of all charges. We will send you reminder emails inviting you to continue your subscription after your free 30-day trial. There is no obligation to continue your subscription after your free trial. We have no long-term contracts. Once you start, you can cancel anytime with no penalty.

Check out our FAQs or email us at hello@HopeCheck.org or call us: 415-209-5122.

TO START YOUR FREE TRIAL, COMPLETE ALL FIELDS BELOW MARKED WITH AN *.

Your Organization or Company Name*

Your Salutation*

Your First Name*

Your Last Name*

Your Work Email Address*

Your Mobile Phone*

Director's*

Check to receive information about how the ACA has authorized approved counselors and professionals to bill insurance or medicare (with no patient co-pay required) for each HopeCheck screening response you receive by using CPT code 96146.