Request for Services
Please complete this confidential form completely and accurately so that we can serve you in a timely fashion. Thank you!
Do you plan on using insurance?
Are you a college student?
Which insurance company do you have? (Please note: We only accept plans for the insurance companies listed below.)
Are you planning to use Employment Assistance Program (EAP)?
Have you seen anouther counselor in th epast 12 months?
Have you ever been seen by a counselor at Freedom Support Services?
Have you been screened for and/or admitted to a pyschiatric facility within the last 12 months?
If there are no openings available, would you like to be added to our waiting list?  
Do you have a preference for the gender of your counselor?
If yes, what is your preference?
Do you have a preference for the race/ethnicity of your counselor?


There are currently six providers in our office. Please check ALL of the providers that you are willing to see. You can learn more about all providers by clicking the links below:









Rosa Jones, Licensed Professional Counselor

Shaterra Walker, Resident in Counseling

Amanda Rigney, Licensed Professional Counselor

Nijera Jones, Licensed Professional Counselor

Chandra Shorter, Licensed Professional Counselor

Hannah Einstein, Licensed Professional Counselor

Jefferson Jones, Chaplin & Life Coach (Does not accept insurance)

Genevieve Drews, Resident in Counseling

Tameesha Curry, Counseling Intern* 

Jessie McGlothlin, Resident in Counseling

Carissa Fraser, Counseling Intern*


Thank you for your interest in our services. We have a high volume of requests and strive to respond to all request for services within 3 business days. If you do not hear back from us, please send a courtesy email to Thank you!