Christine Hurst, L.C.P.C., C.C.P.S.

Certified Coach for Parents & Stepparents

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Individuals:

 

Are you interested in counseling or coaching but do not have the financial means to afford it?

 

Do you satisfy the requirements for those who will be

considered for Christine's Pro Bono Program as listed below?

 

Those who possess the following will be considered for Christine's Pro Bono Program

  • Unemployed
  • Uninsured
  • Underinsured
  • Motivated to participate fully

 Christine's Pro Bono Service is not suitable for the following:

 

  • Substance Abuse Treatment
  • Crisis
  • Serious Mental Illness

Do you have a health care provider or community service             organization provider that will agree to refer you for Christine's Pro Bono Program?

 

Do you agree to allow Christine Hurst to contact the person who is willing to refer you?

 

If you have answered yes to the all of the above, you MUST download the following Referral Form and have your health care provider or a community service provider complete it and return it to you BEFORE scheduling your Pro Bono Telephone Intake Session.

 

Referral Form

 

Once this is completed then the next step is to schedule your Pro Bono Telephone Intake Session online by clicking on the link below:

 

www.christinehurst.clicknet.net

 

Or complete the Contact Form below stating in the message that you would like to schedule a Pro Bono Telephone Intake Session.

 

Please Note: You MUST have a referal from a provider completed before being able to participate in Christine's Pro Bono Program.

 


 

Contact Form

 

* First name (required):

* Last name (required):
* E-mail address (required):

Phone number:
* Message (required):