Good Therapy Counseling -

CONTACT US CONFIDENTIALLY

If you have any questions about our services or would like to schedule an initial session, please submit this form or call our intake line at (630)473-3971.

A member of our Intake team will contact you within 24 to 48 business hours. Good Therapy Counseling is not a crisis center, if you are having a mental health emergency, please call or text 988 (the 24/7 crisis hotline) or go to the nearest hospital emergency room.

Most Recent Inquiry Date *

Full Name *

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Service Requested *

Detail

Who is the visit for? *

Name of the Person Receiving Services

Neurological Testing Inquiries

Neurological Testing: List Symptoms and Behaviors

Educational Consulting Inquiries: Indicate School District and School Name

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Type of Insurance *

Availability: Days and Times *

Therapist Preference *

Additional Information

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