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Individual Teen Services |

Reduced cost of $25.00 per session.

If you are a teenager between the ages of 15 - 18 who lives in Colorado and either does not have familial support to pursue therapy or has a household income of under $28,000, you are eligible to receive individual therapeutic services at a reduced cost of $25 per session. 

 

Please complete the form below TO BE CONSIDERED.

Filling out this application does not guarantee that you will receive reduced cost therapy sessions with Interfaith Bridge Counseling.

Name *
Name
Birthdate *
Birthdate
Phone *
Phone
What is your preferred method of initial contact? *
What is the best day to contact you? *
Check all that apply.
By checking the box below: *
I certify that the above facts are true to the best of my knowledge and belief and I understand that I subject myself to disciplinary action in the event that the above facts are found to be falsified. I also understand that filling out this application does not guarantee that I will receive reduced cost therapy sessions with Interfaith Bridge Counseling.