therapy

Online Appointment Request
 
 

Please note that professional ethics and federal privacy laws mean we cannot offer psychotherapy services or diagnosis by e-mail,
telephone or mail.   If you are having a clinical emergency, or are experiencing uncontrollable feelings about hurting yourself or others, dial 911 immediately or visit your local hospital emergency room.   In the New River Valley you may call 961-8400 for the New River Community Services Board's ACCESS Help Line.

The Family Therapy Center is not an emergency service or hotline and cannot provide emergency support.



Please enter your name, telephone number(s), and best times to reach you
in the boxes below.  Someone will contact you as soon as practical. During times of high demand
it may be three business days before we are able to get back to you.


Name & Phone Number
 
First Name
Middle
Last Name
Full Name
Phone 1
OK to Leave Message?      YES          NO
Phone 2
OK to Leave Message?      YES          NO

 
I Plan To Come In (check any that apply)
With Others (spouse/partner, children, family, etc...)
By Myself
Not Sure

Best Time to Call (check all that apply)
                 Mornings before 8a.m.
      8a.m. to 12p.m.
      12p.m. to 1p.m.
    1p.m. to 5p.m.
After 5p.m.
  

By clicking "Submit Request" I affirm that I have read and understood the Privacy Statement.