Request Appointment

Due to COVID and the use of Telehealth sessions, all new clients must download and complete all forms and paperwork BEFORE the first session, and email them to Covenant.

I am: a New Client an Existing Client

Your Name:

Street Address:

City, State, ZIP:

Home Phone:

Mobile Phone:

Email:

I'd like an appointment on Monday Tuesday Wednesday Thursday Friday

I prefer an appointment in the Morning Afternoon

I prefer an appointment in My Home via Phone in My Home via Video Chat at Covenant Location in Madison at Covenant Location in Decatur at Covenant Location in Hartselle

Additional Information: