creasman counseling, pllc
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Please complete the form if you'd like to join the Men's Group. If you have questions, please reach out to Felix
via email.
*
Indicates required field
Name
*
First
Last
What is your race?
*
Black/African American
Biracial/Multiracial
Indigenous person
Person of Color
My race wasn't listed - I identify as:
*
In the last 6 months have you experienced any of the following:
*
Thoughts of harming yourself
Thoughts of harming others
Hospitalization for mental health concerns
Inability to leave your home or take care of your basic needs due to mental health concerns
None of the above
Email
*
Are you 18 years of age or older?
*
yes
no
Are there other identities that are important for us to know about?
*
Including gender, sexuality, disability, etc.
Have you ever participated in individual or group counseling before?
*
Individual
Group
Both
Neither
Submit
Home
About Us
Providers
Administrative
Leadership
Services
Individual Counseling
Medication Management
Reduced-Fee Counseling
Groups
Clinical Supervision
Resources
FAQs
Rates & Insurance
Good Faith Estimate
Crisis Resources
Practicum & Internship
Podcast
Contact
Client Portal