Request an Appointment
Find Peace, Healing, and Hope Through Faith-Based Counseling
Full Name
*
First Name
Last Name
Contact Number
*
Please enter a valid phone number.
Email Address
*
example@example.com
Preferred day(s) of the week for appointment:
*
Monday
Tuesday
Wednesday
Thursday
Friday
Preferred time of day:
*
Morning
Afternoon
Evening
Preferred location:
*
Please Select
Jenison
Spring Lake
Grand Rapids (Orchard Hill Church)
Fremont
Virtual
Note: our Jenison location has immediate availability
Anything else you'd like us to know?
Please verify that you are human
*
Submit
Should be Empty: