Name

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

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Agreements *

I understand that Reverend Buchanan is not a licensed mental health professional, and that this relationship is for spiritual counseling only. I understand that counseling sessions are $75.00 each, for 50 minutes, and I am responsible for payment prior to appointments. We do not accept insurance. Appointments are conducted over Zoom or by telephone. (Your choice) Cancellations must be made 24 hours in advance. No shows, and late arrivals may result in the client being charged for the session.

I Prefer: *

Phone

Zoom

In-Person