CONTACT US
Individual Appointment Request Form
If you are interested in receiving counseling from Clintonville Counseling and Wellness, please complete our appointment request form and our Client Care Coordinator will be in touch with you shortly.
Relationship Appointment Request Form
If you are interested in receiving relationship counseling from Clintonville Counseling and Wellness, please complete our appointment request form and our Client Care Coordinator will be in touch with you shortly.
Intern Appointment Request Form
If you are interested in receiving counseling from an intern at Clintonville Counseling and Wellness, please complete our appointment request form and our Client Care Coordinator will be in touch with you shortly.
Gender Affirming Letter Appointment Request Form
If you are interested in a free gender affirming letter for transition related medical care, please complete this form to request an appointment.