Family Counseling

Please complete each of the following steps to begin services:
1. Click HERE to schedule a phone appointment with our Referrals Team
2. Fill out the form below (form is required for the meeting with the Referrals Team)
3. Speak with our Referrals Team to verify eligibility, complete your chart setup & schedule an Initial Intake with your provider.
4. Begin on your path to growth & wellness!

To begin services, please enter the following information*:

Please confirm the services being requested: *

Individual Counseling 18+ Individual Counseling 12-17 Years of Age Individual Counseling Under the Age of 12 Couples Counseling Family Counseling

* Indicates required field

Please provide the full name, email address and phone number for each person that will be participating in services: *

Do all parties give consent for us to contact them via email? *

If all parties do not give consent for us to contact them via email, please provide the full name and email of those who do not consent: *

If any participants are minors (under 12 years of age), do both parents/legal guardians consent to the minor's participation in services? *

If both parents/legal guardians of the minor(s) (under 12 years of age) do not consent to the minor's participation in services, does one parent/legal guardian hold sole medical decision making power and have documentation of such? *

If "No" was selected above, or supporting detail is required, please place it here: *

Location Preference *

Type of Payor *

Type of Insurance (if applicable) *

Name of Insured *

Member ID/EAP Authorization Number *

Date of Birth of the Person Receiving Services *

Preference *

Appointment Day Preference *

Appointment Time Preference *

Are you looking for an LGBTQIA+ affirming/ally clinician? *

Are you a previous client of Barber Family Counseling & Wellness? If so, who did you used to work with? Would you prefer to work with them again if there is an opening? *

Is there a specific clinician you would prefer/have been referred to work with? *

Submit

*By filling out this form, you are consenting to the use of electronic communication. If you do not consent to the use of electronic communication, you may also call our office to begin services at (866) 644-6131. Please note that our phone line hours are limited at this time to Monday through Thursday. Voicemails left will be returned within 5 business days.

Locations

Barnes Rd., Colorado Springs, CO
4775 Barnes Rd. Ste L
Colorado Springs, CO 80917

Briargate Blvd., Colorado Springs, CO
3475 Briargate Blvd. Ste 201
Colorado Springs, CO 80920

Las Vegas, NV
1771 E Flamingo , Ste 220-B (Bldg B)
Las Vegas, NV 89119

Phone: (866) 644-6131
Billing Questions: (866) 644-6131 ext 701
Fax: (719) 434-9615
wellness@barberfamilycounseling.com

If you or someone you know is in crisis, call 911, go to the nearest emergency room, or call 1-800-273-TALK (8255) to reach a 24-hour crisis center.

You matter and you are never alone.

Barber Family Counseling and Wellness is proud to support our military member and veterans.

YOUR CART

To begin services, please enter the following information*:

Locations