Minors and Families | Sessions and Fees | Locations

Adult Intake Form

Following are the steps to get started with counseling:

  • Complete the intake form.
  • Submit the intake form.
  • The Services Coordinator will contact you about scheduling and fees.
    • From the time the intake form is submitted, it generally takes a week to be matched to start scheduling with a counselor.

Due to high demand, there are delays for evenings and Saturday appointments. Please consider daytime and lunch appointments if possible.

Please note that you will be asked to sign the Counseling Agreement before scheduling your first appointment.

Download the intake form

Submit the Intake Form

Email: rcs@redeemer.com
Fax: 212-252-0649

Mail or drop off at the main office:
1166 Avenue of the Americas, 16th Floor
New York, NY 10036


Minors or Families

Following are the steps to get started with counseling:

  • Contact the Services Coordinator to send you the intake and consent forms for minors and/or families
  • Complete the intake form(s).
  • Once the intake form(s) are submitted, the Services Coordinator will contact you about scheduling and fees.

Please note: it takes around one week to schedule the first session once the intake forms are submitted.

Required forms for Minors

  • Minor Intake Form
  • Consent for the Treatment of Minors

Optional forms for Minors and Parents / Guardians

  • Adolescent Intake Form
    • This form is optional for adolescents ages 13 to 17 years old. It is an opportunity for the adolescent to give his or her own input of concerns.
  • Adult Intake Form (Word doc. format)
    • This form is optional for adults participating in family counseling to provide any additional imput of their concerns.
  • Application for Sliding Scale Fee

Restoring lives with truth and grace