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Request a consultation or ask a general question.
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- Include: Your goals, availability, service interest, general questions
- Avoid: Sensitive personal details, detailed trauma history, or urgent crisis information
If you're not sure what to write, that's okay. A brief note about what you're looking for is enough.
Direct contact
Phone
(555) 555-5555Location
Bloomington, Indiana
Telehealth across Indiana
Licensed Social Worker (MA, LSW)
Hours
Placeholder hours (e.g., By appointment)
Important
Safety and privacy
Do not use this form for emergencies.
If you are in immediate danger call 911. In the U.S., call/text 988.