North Oakland Counseling, LLC - SCHEDULE AN APPOINTMENT - Rochester, MI
North Oakland Counseling LLC   (248) 266-1953 - Therapy & Counseling for Individuals, Couples & Families
Schedule an Appointment 


North Oakland Counseling To arrange for an appointment please fill out the contact form below and send it.  Make sure to include your email address and your phone number.  We will make every effort to contact you promptly 
(All information sent will be treated as confidential information and will not be shared with any third parties)

Note: If you are seeking marriage counseling please check with your health insurance prior to submitting  this form as the majority of health insurances DO NOT cover marriage counseling.

CONTACT FORM
First Name
Last Name
Date of Birth (for health insurance verification)
Phone Number
May we leave you a message at this number?
Yes
No
Best time to reach you?
Email Address (a valid email address is required)
May we contact you by email?
Yes
No
What type of counseling are you requesting?
OTHER? please explain
Appointment Requested
Therapist Requested
Health Insurance Information so we can verify your benefits (If available) 1- Name of Insurance Plan 2- Id Number
Insurance Phone Number (found behind the insurance card)
Additional Information / Questions



 
 (Individual counseling, family counseling, couples and marriage counseling, counseling for children and adolescents, counseling for depression & anxiety, anger management, grief and trauma counseling, Rochester, Michigan) 
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