New Client Waitlist | Scheduling Preferences


Completion of this form does not guarantee that you will book an appointment with one of our providers. This form holds your place in line for the next available appointment that matches your needs. When an appointment becomes available, the first person that matches will be notified. If a reply is not received, we will reach out to the next person in line. DO NOT submit this form if you are currently experiencing a mental health crisis. Call your local mental health crisis center or go to your nearest emergency room.

I would like to schedule an appointment for:


Would you prefer virtual or in-person sessions? 


If you are interested in coming to the office for in-person sessions, please select mask preference:

Are you a returning client?

Select 'yes' if you have been seen by a provider at Bull City Counseling in the past.

What is your health insurance plan?


Do you have a preferred provider?

Multiple selections are encouraged. The more flexible you are, the quicker we will be able to find a match for you. 


Please select start times that could work for you.  We do not offer evening or weekend appointments.


By entering my name, I acknowledge and understand that this form does not guarantee an appointment with a provider and I agree to seek immediate mental health care if an emergency arises.

By entering my email address below, I acknowledge and understand that I will receive email(s) from Bull City Counseling..  I understand that I may remove this authorization at anytime by request to:


We will be back in touch when we have a provider that meets your needs.