LifeWorks Counseling Thank you for your interest in seeing a counselor. Counseling is free for youth 24 & Younger. Please fill out this form and someone will reach out to you to setup an initial intake appointment. OK Question Title * 1. First & Last Name: OK Question Title * 2. Age: OK Question Title * 3. Gender Pronoun: OK Question Title * 4. Phone: OK Question Title * 5. Email: OK Question Title * 6. Best days/times you are available for sessions: OK Question Title * 7. Have you been to therapy before? OK Question Title * 8. What you hope to get from therapy? OK DONE