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

Organizations: 

Would you like to refer someone to Christine's Pro Bono Program?

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

To Make a Referral:

Please complete the following Contact Form with the following information:

Your First Name (person making the referral)

Your Last Name

Your Email Address

Your Phone Number

In the message please include: 

Client Name

Email

Phone Number

Reason for Referral

If I have an immediate session or slot available I will request, with a signed release of information, to be able to contact you.

You may also download the referral form and fax it to #800.341.1075

Referral Form

Contact Form