Intake Request Form

Please fill in the Intake Request Form to request an intake session with an SCCC counselor.  As a result of the Covid-19 pandemic, all intakes are being performed via video conference.

Please note, there is a $20 intake session fee that will be due via credit/debit card when your intake is conducted.  Intake fees vary for the The Abuse Prevention Program.

If you think you may have a medical or mental health emergency, please call 911.

After completing an intake, you will be placed on our wait list to be assigned a counselor for ongoing therapy.  The current waitlist is:
Individual Counseling: 6-7 months
Couples/Family Counseling: 1 month