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Person you are referring #1*

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Birth date*

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Person you are referring #2*

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Person you are referring #3*

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Person you are referring #4*

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Person you are referring #5*

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Person you are referring #6*

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What you are seeking*

Child/parent substance abuse*

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No

Co-occurring substance abuse/ mental health disorder*

Yes

No

At risk of harming self/other?*

Yes

No

What is your reason for seeking counseling?*

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LOCATE US

13707 Fairhill Avenue
Edmond, Oklahoma 73013

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CONTACT US

EMAIL: information@teampathways.com
PHONE: (405) 607-4041
FAX: (405) 463-0090

SERVICES

Individual Counseling
Family Counseling
Couples Counseling
Child/Teen Counseling
Coaching