In Person Waiting list Form

This waiting list form is for those wanting to be seen by Jackie or Elias DaHora in person. Our services are primarily virtual, with limited in-person meeting options at local venues such as churches, coworking spaces, or coffee houses within the Lenoir City, TN area. We advise starting with online counseling promptly, transitioning to in-person sessions as they become available. Virtual/Online is available now.

Please review our frequently asked questions page before filling out the form. www.therapeacecounseling.org/faq

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

How did you hear about Therapeace Counseling?

Please provide a short description for the need of counseling.

Please specify if its for a minor.

Select session type

Please make sure you have reviewed our frequently asked questions page before selecting. www.therapeacecounseling.org/faq

Individual Therapy Session with Jackie using Insurance

Individual self-pay session with Jackie

Individual self-pay session with Elias

Marital self-pay session with Elias

In Person Waiting list Form

If you are in a life threatening situation, do not use this site . In case of an emergency, call 911 or go to your nearest emergency room. Click here for more hotlines and helplines for suicide, domestic abuse, postpartum depression, and sexual assault resources.