Let’s Work Together

Interested in working together? Fill out some info and we will be in touch shortly! We can't wait to hear from you!

For other questions, we can be reached at:
Email: info@guidedhopecounseling.com (quickest response)

Phone : (410) 846-0095 (messages usually returned within one business day)

Name of Client

First Name

Last Name

Date of Birth of Client

YYYY

Name of Parent/Guardian (for minor clients)

First Name

Last Name

Email (for adult clients or guardian of minor)

Phone (for adult clients or guardian of minor)

(###)

###

####

What service(s) are you interested in?

Individual Therapy

Family or Couples Counseling

Art Therapy

What location(s) do you prefer?

Bel Air Office (in-person)

Towson Office (in-person)

Telehealth (virtual)

Is there a specific therapist you would like to work with if available?

What is your insurance?

What specific days of the week is the client available for appts on a regular basis?

What specific times is the client available for appts on a regular basis? (For minors who attend school, we will only schedule around their school hours). For example: 3pm or later; 12-1pm; etc.

Brief description of why you are seeking counseling:

Let’s Work Together

Guided Hope Counseling, LLC