Need someone to talk to? Family issues? Parenting issues?
Relationship issues? Depressed? 
We'd like to help.

You can take the first step in feeling better by talking to a therapist at Family Counseling Center. If you live in the middle Georgia area and would like to schedule an initial counseling session, you may either complete the form below and submit it online immediately, print and fax it to 478-745-0881 or mail it to us. Someone from our staff will contact you the next business day after receiving your information. You may also call at 478-745-2811 to schedule an appointment.

Note:  Fields marked with an asterisk (*) are required.

Your Full Name*
Home Phone*
Cell Phone
Street Address*
Date of Birth
Sex Male    Female   
Ethnicity African-American    Caucasian    Hispanic    Other 
Spouse's Name
Have you received counseling services from our office before?
  Yes    No   
If so, when?
Who was your counselor?
Most convenient time for our staff to contact you
What is the issue you are concerned about?