KIPP Forward Mental Health Therapy      Pre-Enrollment Form

Please complete this 5-minute form to request free therapy sessions. Note that this form requires your Salesforce ID #, which your advisor (or another KIPP Forward staff member) can provide to you.   

Health insurance is NOT required to receive mental health services offered by KIPP Forward -  our short-term service providers will be free to alumni in our program regardless of health insurance status. 

Once you submit this form, you will receive an email within 2 business days with instructions for getting set up with your therapist. Alumni will be approved for up to 6 sessions at a time. Additional sessions are not guaranteed, however can be requested upon completion of the first 6 sessions.

If you or someone you know is struggling or in crisis, call or text 988 or chat 988lifeline.org to reach the 988 Suicide & Crisis Lifeline. If you are in crisis, we encourage you to seek immediate assistance.

If you are in need of immediate support but are not in crisis, please contact Nicole Kabalkin at NKabalkin@kippnyc.org / 917-584-0824 or Charles Small at CSmall@kippnyc.org / 839-216-9946.


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