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Mandated Therapy Request

"*" indicates required fields

I understand that The Wounded Healer Project is only able to provide counseling services in the state of Colorado.*
Your Name*

Client Information

Client’s Full Name*
MM slash DD slash YYYY
Client’s Current Address*
If in transitional housing or inpatient, please provide name of facility.
Is the Client VA eligible?*
Does the Client have insurance?*
Does the client have access to a device that they can complete telehealth services on?*
(i.e. has video capabilities)
Does the client have access to a stable, secure internet connection?*
Does the client have access to a private space that they can complete telehealth services?*
Does the client have access to transportation for in person appointments?*

Hours & Info

Location: We are currently located in the Denver Metro area and serve the Eastern Colorado region.

Hours: 9am-5pm

Days: Monday – Friday

Direct Contact

Tim: 706-536-7897 | tim@thewhp.org

Tegan: 303-525-7660 | tegan@thewhp.org

Email: contact@thewhp.org

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