Counseling Services

LGBTQ Counseling Services Provided:

*STONEWALL COLUMBUS IN-HOUSE COUNSELING DOES NOT ACCEPT PRIVATE INSURANCE OR MEDICARE PRIORITY GOES TO THE UNINSURED OR THOSE ON MEDICAID

Stonewall Columbus Counseling Form

Please fill out this form to request an intake with a counselor at Stonewall Columbus. A counselor will contact you within 1-2 business days.

"*" indicates required fields

Legal Name*

First Last

Preferred Name*

First Last

Email*

Phone*

Can we leave a voicemail?*

Yes

Which name would you like us to use when we call?*

Legal Name

Preferred Name

Do you have medical insurance?*

Yes

If yes, what type of insurance?

Brief reason for seeking counseling:*

If you have any questions, please call North Central Mental Health Family Focus at 614-227-6865 and ask to be connected to one of our therapists.

Counseling Provided by North Central Mental Health Services

Stonewall Columbus counseling services are subsidized
by funding from The Franklin County ADAMH Board.