These forms are intended for use by physicians, psychiatrists, teachers, administrators, psychologists, school counselors, clergy and after school programs in making referrals for my therapeutic services. Please get consent from the person you are referring, before sending in the referral form.
Thank you for choosing my services to help!
Call: 760-978-6071
You can order more full color brochures and business cards on the form below, to give to those you think will benefit. The default quantity that will be mailed to you is 10 business cards and 10 brochures, unless you specify otherwise in the message portion of the form. If you need individual tissue packs with counseling referral information on them for your more tearful visitors, please indicate so on the form. The default quantity for tissue packs is eight. Kristin's Comfy Couch Counseling Lifesaver referral candies are shipped in quantities of 50, unless otherwise specified.
Call: 760-978-6071