Mental Health Association of Central Florida

Orlando United Counseling Intake Form

In response to the recent Orlando tragedies we are offering the Orlando United Counseling Program to help our community heal.

Orlando United Counseling is providing confidential, personalized, long-term counseling to anyone impacted. Individual, couples, and group counseling is being offered for free and is available to anyone in need. English and Spanish services available with flexible hours.

If you’d like to be connect to services call 407-898-0110 or fill out the referral form below.

Your Name
Your Address
City
Zip
Phone
Email
Age
Date of Birth
Race
Gender
Language
Availability for Counseling:
Mon     Tue     Wed     Thu     Fri     Sat
Hours
How do you feel you were impacted by the Orlando tragedy?

 

“A COPY OF THE OFFICIAL REGISTRATION & FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE (800-435-7352) WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.” (Registration #CH 1245)