Contact - Paper Bridge Counseling

If you're ready to take the first step, you're in the right place. Fill out the form below to begin the process.

*A quick heads-up: this form may not meet HIPAA privacy standards. For your privacy, please avoid including detailed personal or health-related information.

If this is an emergency, please call 911 or 988 or the National Suicide Prevention Lifeline at 800-273-8255.

Full Name

Phone

Date of Birth

Tell me a little about why you are seeking therapy.

Ability to Pay

Have you ever worked with a therapist before?

Yes

How did you hear about Samantha/Paper Bridge?