top of page
Image by George Bakos

Request Counseling Services or Submit a Referral

Many individuals connect with our practice through referrals from professionals, community organizations, and trusted networks. If you are seeking counseling services for yourself or referring someone for care, please complete the referral form below.

​

Our practice provides counseling services designed to support emotional wellness, personal growth, and resilience through evidence-based and integrative therapeutic approaches.

​

​After submitting the form, a member of our team will review the information and follow up within 1–3 business days if the referral is appropriate for our services.

Emergency Disclaimer

Important Notice

This referral form is not intended for emergencies or urgent mental health situations. If you or someone you know is experiencing a mental health crisis or is in immediate danger, please contact:

or

This form can be used by:

  • Individuals seeking counseling services

  • Family members helping someone connect with care

  • Therapists or healthcare providers referring a client

  • Community organizations or faith leaders making a referral

Service Areas

​We provide counseling services through secure telehealth sessions. Clients must reside in a state where services can legally be provided. Services are currently available to clients located in:

  • Georgia (Client can be seen in person in Loganville and Covington GA)

  • Florida

  • South Carolina

  • Oregon

  • Washington

What Happens After Submission

Once the referral form is submitted:

  1. The information will be reviewed by our practice.

  2. If appropriate, the individual will be contacted to discuss next steps.​

  3. We will determine whether our services are a good fit and review scheduling options.

​

​Submitting a referral form does not guarantee services, but it allows us to determine the best next step for care.

Complete Referral Form

Request Counseling Services or Submit a Referral

Many individuals connect with our practice through referrals from professionals, community organizations, and trusted networks. If you are seeking counseling services for yourself or referring someone for care, please complete the referral form below.

​

Our practice provides counseling services designed to support emotional wellness, personal growth, and resilience through evidence-based and integrative therapeutic approaches.

​

After submitting the form, a member of our team will review the information and follow up within 1–3 business days if the referral is appropriate for our services.

Emergency Disclaimer

Important Notice

 

This referral form is not intended for emergencies or urgent mental health situations. If you or someone you know is experiencing a mental health crisis or is in immediate danger, please contact:

​

988 – Suicide & Crisis Lifeline

or

Call 911

This form can be used by:

  • Individuals seeking counseling services

  • Family members helping someone connect with care

  • Therapists or healthcare providers referring a client

  • Community organizations or faith leaders making a referral

Service Areas

We provide counseling services through secure telehealth sessions. Clients must reside in a state where services can legally be provided. Services are currently available to clients located in:

​

  • Georgia (Client can be seen in person in Loganville and Covington GA)

  • Florida

  • South Carolina

  • Oregon

  • Washington

What Happens After Submission

Once the referral form is submitted:

​

  1. The information will be reviewed by our practice.

  2. If appropriate, the individual will be contacted to discuss next steps.

  3. We will determine whether our services are a good fit and review scheduling options.

 

Submitting a referral form does not guarantee services, but it allows us to determine the best next step for care.

Complete Referral Form

mending minds logo

We believe that mental health professionals are often so focused on caring for others that they may neglect their own mental health needs.

Quick Links

Home

About

Blog

Announcements

Contact

Self-Care Corner

Read, Reflect, Rejuvenate

Craft Your Calm

Therapist's Retreat

Counselor's Comfort Collection

Follow Us

  • Instagram
  • Facebook

Services

Collaboration

Personalized Individual Services

Individual Counseling

Individual and Christian Counseling

Mental Health and Success Coaching

Individual and Group Hypnosis Session

Sound Therapy

TIME

EFT

TAg
TAG
TAG
Tag

© 2026 Mending Minds. All rights reserved.

bottom of page