Please complete the form below to request a new client appointment.
We’ll do our best to respond as quickly as possible.
How did you find us?
Dr. Sandra Bruno, Licensed Therapist
Sarabeth Bozeman, Licensed Therapist
Marcy McClain, Licensed Therapist
Becky Moerbe, Licensed Therapist
Kaylee Newton, Licensed Therapist
If You Have a Preferred Counselor, Please Select Them Below
Mary Emeline Dawson, Licensed Therapist
Teal Dick, Licensed Therapist
Jerri Doblestein, Licensed Therapist
Beverly Ward, Licensed Therapist
Donda Goodson, Licensed Therapist
Do You Plan To Use Insurance?
Please upload your insurance card (front and back) and driver’s license (front) so we can check your benefits. If you can’t do this now, you may provide them later.
Please Indicate Your Preferred Location
Insurance Information
Dr. Bill Brunson, Pastoral Counselor
Nic Jones, Intern
Nikki Sims, Intern
Hunter Wright, Intern
Informed Consent for Electronic Submission
By submitting this form via this website, you acknowledge and accept that any information you share in the form could possibly be seen by others because this is unencrypted communication.
By providing your phone number, you consent to receive SMS text messages from Still Waters Counseling & Education Center (SWCEC) regarding your appointments, scheduling and other business maters. You may see our SMS texting Terms and Privacy Policy at: https://www.mystillwaters.org/sms-terms-and-privacy-policy
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