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 *

Acknowledgment *

I understand that this form is not a secure or confidential method of communication. I agree not to include sensitive or private health information in this message and acknowledge that submitting this form does not establish a client-therapist relationship.

Submit

Let's stay in touch!

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

Mailing Address

P.O. Box 123737
Fort Worth, TX 76121

Telephone

(682) 219-8733

Email

[email protected]

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

Equine Assisted Counseling Interest Form

Let's stay in touch!

Subscribe to our email list

Mailing Address

Telephone

Email