COUNSELING INTAKE APPLICATION
To receive counseling or to schedule an appointment:
Please call the Office (513) 729-7008 for a 20 minute telephone conversation to complete intake information for matching you with a Volunteer Peer Counselor.
Adam Center, LLC does not guarantee complete confidentiality of any information sent electronically.
A completed applications is required to be filled out prior to seeing a peer counselor.
You may complete this online application. It will be sent to the Director when you click “send email” at the end of the form below: