Counseling Interest Form

Equine Assisted Counseling Interest Form

Please complete this form to be contacted about STEPS' services. As online forms are not secure, please do not include detailed personal information about your concerns.

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Is it ok to contact you by text message? *

Yes No

Who is the Equine Assisted Counseling for? *

Myself Someone else

If someone else, please indicate the individual's age and your relationship to this individual *

Military Clients *

Please check the box if you are a military veteran, service member, or family member

Any additional comments *

Please note: This form is not secure. Please refrain from including confidential or privileged information in this form.

Submit

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Donate to S.T.E.P.S. With Horses

Mailing Address

P.O. Box 123737
Fort Worth, TX 76121

Telephone

682-219-8733

Email

office@stepswithhorses.org

A Texas Nonprofit Corporation and a 501(c)(3) Tax-Exempt Charitable Organization

Equine Assisted Counseling Interest Form

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Mailing Address

Telephone

Email