Free Therapy Voucher Request Form - Community Organizations
Thank you so much for your interest in helping further our mission of providing free online mental health appointments to people in need. We hope that our services can be of help to your constituents!ย 

Please fill in your organization's contact information below, and we will be in touch soon with specifics on how your constituents can sign up for 3 months of completely free, online therapy sessions.

Regardless of previous mental health diagnoses, therapy can help anyone gain new perspectives, navigate challenges, and lead a more fulfilling life!ย ๐Ÿ’™

If you have additional questions as you fill out this form, please reach out to us atย info@freetelehealth.org.
See our website here for more detail:ย freetelehealth.org
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Organization Name *
Your Name (optional)
Email Address *
Briefly describe the demographics of the population your organization works with (optional)
Approximately how many people does your organization serve/work with? (optional)
Comments/Thoughts/Questions (optional)
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