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FAMILY APPLICATION FORM

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For more time-sensitive requests, you can reach our intake counselor by calling (352) 209-3513

All office visits are by appointment only. Evening counseling sessions are available by appointment only. 

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FAMILY 

Program Application

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Looking to learn more about My Life Counsel's FAMILY program or the FAMILY Parenting class?​ Please fill out our form below!

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        Parenting classes are free and are available to all, through a grant by Marion County Hospital District. Due to limited availability, therapy sessions may require a lengthier enrollment process. Inquire by filling out the application found on this page.

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