Counseling Request Form
Our experienced counselors are personally and professionally committed to a Christ-centered life and able to counsel individuals, families, couples, or children/teenagers!
You may just be seeking some direction in your life or facing important decisions. You may be changing careers or navigating relationship difficulties. You may be dealing with a more serious issue such as the loss of a loved one, a parenting struggle, anxiety, depression or healing from trauma.
No matter what your current situation is, there is hope because God is there. Our experienced counselors apply Biblical principles and psychological methods while helping you develop a personal plan for your growth and transformation.
We serve Victory Church members/attendees and the greater Lakeland community regardless of your religious affiliation. Once you've submitted this request you should hear from someone within two business days.
All information (verbal or written) shared in regards to or during professional counseling at Victory Counseling is kept strictly confidential (as is the legal requirement). Except in a small number of situations, the helping professional may not reveal any information about you to another person without your explicit written permission.
One exception to this rule is In cases where a relevant court order has been issued and records have been subpoenaed by a Judge, the counselor has a legal responsibility to comply.
Another exception where counselors are legally required to disregard confidentiality involves situations where there is a potential for suicide or homicide. For example, if you reveal information that indicates a clear danger of injury to yourself or others the counselor will need to contact the appropriate authorities or family members.
The final exception to confidentiality is that all helping professionals are required by law to report any knowledge of abuse or neglect of a child or an incompetent or disabled person including suspected abuse to the appropriate authorities.
Person Making Request
Request Contact Number
Request Contact Email
Briefly describe your need along with special challenges
If "Other" please list
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