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APPOINTMENT REQUEST

If you would like to schedule an appointment, fill out the form below. We will email as soon as we have an opening that matches your preferences. We do NOT offer immediate appointments or emergency services. If you are experiencing a mental health crisis or have suicidal thoughts, please call 911 or go to the nearest emergency room.

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Returning client?

Multiple selections are encouraged. 

Preferred Provider

When are you available for appointments?

Select all start times that could work 

MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY

By submitting this form, I acknowledge that I am not guaranteed an appointment and I agree to seek immediate mental health care if an emergency arises.

I consent to email follow-up and internet transmission of my form entries to info@bullcitycounseling.com for the purpose of scheduling. I understand that email is not HIPAA compliant and  I may remove this authorization at anytime by request to: info@bullcitycounseling.com

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