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Haven Family Counseling

Thank you for completing this referral form. A member of our team will contact you. You can also reach us by calling 502-451-4701.

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Name of Parent/Guardian (if applicable):

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Service(s) Requested:

Individual Therapy

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Are you currently working with another behavioral health provider?

Have you worked with a behavioral health provider in the past?

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2301 Goldsmith Lane, Louisville, KY 40218
Phone: 502-458-1171

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