Register

Registration is only required if you do not have a username. Please check your spam & junk mail folders to ensure you have not already received an email with a username and password. If you already have a username log in here

Each account must have a unique email address associated with it. Please contact us if you need multiple accounts with the same email address (i.e. related family members).

Welcome! Initial Registration is a short basic form. Once you are logged in and do the quick form the complete New Patient information packet is released to you. Counsol will notify you of new information/emails from your therapist.

Client Type

Client Information

/ Middle Initial

( optional )
 






( for Text Message Reminders )


Emergency Contact

First Name
Last Name
Phone
Mobile
Relation
Email
Street Address
City
State
ZIP Code

Log in Details

( If client is a minor, the legal guardian must enter their email address below. )



Between 8 and 40 letters and numbers