Request Form
We're so glad you're interested in Brave Trails Queer Therapy at The Relational Center! Please fill out this form with as much information as possible to help us better understand your needs and interest in therapy.
If you're 12 or older, you can fill out this form by yourself.
We can't promise you'll be able to get services without a parent or guardian involved, but we're happy to talk with you on the phone about what options you might have.
If you have any questions, please call us to find out more about this program:
(323) 935-1807.
Note: This program is specifically for LGBTQ+ youth & their families seeking counseling services.
Looking for our general intake form? Follow this link!
Interested in joining one of our queer-affirming youth & family support groups? Email the group facilitators found under each group listing!
Taking the first step towards building more support in your life takes courage. We’re honored to be one of the resources you are reaching for.
As you fill out this form, the more information you are comfortable providing, the better. The information you submit here will not be shared with anyone outside of The Relational Center.
If you are more comfortable speaking with someone over the phone to submit your request, we welcome your call.
If you have already submitted a request, you can expect to hear back from us within two weeks. You are welcome to contact us for an update on your waiting list status.
We’re excited to connect with you!
Brave Trails Queer Therapy Request Form
Before you go any further, this form is only for LGBTQ+ individual & family counseling services!
If you want to join a support group, please reach out to the facilitator emails found under each group listing.