All clients are seen on an appointment basis. Telephone the office in advance to schedule an appointment time or fill out this form and let us know when is the best time for you.

PERSONAL INFORMATION
Full Name:  
Age:  
Gender:   Male  Female
Address:  
City:  
State:  
Zip Code:  
Phone (H):  
Phone (W):  
E-Mail:  

Briefly describe your problem:

What day and time would be best for you?

Do you have Health Insurance:
Yes  No

Would you like us to send you more information:
Yes  No

  

 

 Goal of Our Counseling:

To renew peace, hope and joy in the lives of God’s people.
Cornerstone Counseling • 6 Naughright Road • Hackettstown, NJ 07840
P: 973-584-1370 • Info@CornerstoneCounseling.net