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Counselee Registration Form

Anchored Biblical Counseling

Register For Services
At Anchored Biblical Counseling, you’ll find counselors who reflect Christ’s grace—listening with compassion, guiding with Scripture, and walking beside you toward emotional and spiritual wholeness. 

“The Lord is near to the brokenhearted and saves the crushed in spirit.” — Psalm 34:18


Gender
Birthday
Month
Day
Year
Session Requested (For Marriage & Family sessions, each person should fill out their own registration form unless they are a minor.)
Type of Visit
Are you requesting counseling for a minor (under 18)
Yes
No
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