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Pastoral Advising

The purpose of this form is to determine if clinical counseling is warranted and/or to make a viable non-clinical resource recommendation.

First Name

Last Name

Email

Best contact phone number

What type of advising do you need?

Personal Advising

Relationship Advising

Who is this request for?

Myself

My partner

My child (under the age of 18)

Friend/Myself & an EWC Partner

Other

Please describe your current situation or issue:

What are your expectations during advising?

Other than applying today, what other steps have you taken to address this issue?

Are you or the person in need currently in counseling?

Are you or the person in need currently on prescribed medication(s)?

Are you open to try other viable options, resources or recommendations that our team believes will assist in rectifying your concern / issue?

Is there any additional information that we should consider?

Thanks for submitting!

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300 Westgate Dr. Park Forest, IL | Sundays 3pm CST

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