Counseling Center - The House Modesto

Phone number *

Birthday *

Type of Counseling *

Do you have children? *

Do you attend The House? *

Are you a leader or mentor in any ministry? *

Check any of the following classes that you are or have been involved with: *

H Group's

H Classes: Become Marriage, Freedom, Holy Spirit, Knowing God's Word, Recovery

Kingdom Men

Beautiful Warrior

Other

Have you received mentoring from anyone at The House before? *

Mental Health Disorder

Are there any of the following conditions involved?

Choose any that apply

Mental Health Disorder

Substance Abuse

Other