Counseling Request


Submit your counseling needs here. We are here to help and care for you!


***If nobody has contacted you back within five business days, please call our office at (210) 402-0565 so we can get you connected with someone***

Please bring this PERSONAL AGREEMENT FORM and bring it to your first counseling session.

Counseling Request Form

First Name*:

Last Name*:



Why are you requesting an appointment?

List days and times you might be available to meet.

Counseling Intake Forms

If you have already requested counseling and made an appointment with our counselor, please print and fill out the attached form and bring it to your first appointment. Bringing the filled out form to your first appointment will help us to better asses and address your individual needs. We are here to help and look forward to meeting with you!

Counseling Intake Assessment Form

Live Out Loud. Live Bold!

  • Connect With Us

  • Fellowship One
  • Service U
  • My Summit
© 2018 Summit Christian Center - Live Out Loud. All Rights Reserved. | Backstage
San Antonio Website Design & Development - Backyard Studios