Request to Work With Dr. Anika
Dr. Anika Wilson-Brown, MSW provides one-on-one and group services to support you in this life's journey. Services include: Therapeutic Coaching, Spiritual Counseling, Couples Counseling, Pre-Marital Counseling, Power Parties (a Group Coaching experience in your home with friends or family), Weddings and Vow renewals, Baby Blessings, House Blessings, and Intercessory Work & Healing Rituals. Please complete this form to request her services. This form is a request for to gather information and should not be considered a confirmation. Anika believes in the power of presence and looks forward to serving you. Upon receipt of all pertinent details, the AWB Experience team will be in contact with as soon as possible. Thank you and may God bless you ABUNDANTLY!
Personal Information
Name
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Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Person Email
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example@example.com
Phone Number
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Area Code
Phone Number
Membership Status at Union Temple Baptist Church (UTBC)
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Member
Recent/Frequent Visitor
Relative/Friend of Member
Not connected to UTBC
Service Being Requested
Please share the details of your needs so that Anika can best serve your needs.
Please share the reason for your request. The information will be kept confidential. Please select all that apply.
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Therapeutic Coaching
Spiritual Counseling
Power Party
Couples Counseling/Pre-Marital Counseling
Wedding/Vow Renewal
Baby Blessing
House Blessing
Rituals/Intercessory Work
Meeting Request
Interested in Spiritual Mentorship
Present a Business Opportunity/proposal
Request Media Interview
Please describe any specific needs that you think we should know below
If there is a specific Date Requested, please indicate it here
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Month
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Day
Year
Date
If for an Event (Baby Blessing, House Blessing, Wedding) Start Time
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Hour
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Minutes
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AM/PM Option
Event Ending Time
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Hour
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30
40
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Minutes
AM
PM
AM/PM Option
Event Address if different from Address above
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Have you used AWB services previously?
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Yes
No
Submit
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