Complete your
Advocacy Form Here

Lead Healthy Retreats Advocacy Form

Thank you for your willingness to consider serving as an advocate! We understand it is both a sacrifice and privilege to come alongside someone who needs care during this season of life. This form will help us better understand how we can best prepare for our time together.

"*" indicates required fields

MM slash DD slash YYYY

Counselee's Name*

Thank you again for taking the time to fill out this form!

We will be reviewing all the forms related to this case before letting the counselee(s) know some tentative dates for your time with us. Please connect with the counselee(s) to coordinate your schedules.

This field is for validation purposes and should be left unchanged.