{"id":68,"date":"2019-10-30T02:48:21","date_gmt":"2019-10-30T02:48:21","guid":{"rendered":"https:\/\/hopeinhealingfamilyservices.com\/?page_id=68"},"modified":"2023-12-06T14:12:05","modified_gmt":"2023-12-06T14:12:05","slug":"contact-us","status":"publish","type":"page","link":"https:\/\/hopeinhealingfamilyservices.com\/?page_id=68","title":{"rendered":"Contact Us"},"content":{"rendered":"<p>Contact us by phone, email or through our contact form. If you are an existing patient, you can log into your account by visiting <a href=\"https:\/\/hopeinhealing.theraplatform.com\/#\/login\">hopeinhealing.theraplatform.com<\/a><\/p>\n<h3>Hope In Healing Family Services, PLLC<\/h3>\n<p>Phone: 252-495-0554<\/p>\n<p>Email: <a href=\"mailto:mjernigan@hopeinhealingfamilyservices.com\">office@hopeinhealingfamilyservices.com<\/a><\/p>\n<h3>Forms<\/h3>\n<p>Session Fees &#8211; <a href=\"http:\/\/hopeinhealingfamilyservices.com\/wp-content\/uploads\/2022\/08\/Session-Fees.pdf\" target=\"_blank\" rel=\"noopener\">Download<\/a><\/p>\n<p>Referral Form &#8211; <a href=\"http:\/\/hopeinhealingfamilyservices.com\/wp-content\/uploads\/2022\/08\/Referral-Form.pdf\" target=\"_blank\" rel=\"noopener\">Download<\/a><\/p>\n<p>New Client Information &#8211; <a href=\"http:\/\/hopeinhealingfamilyservices.com\/wp-content\/uploads\/2022\/08\/New-Client-Information-Sheet.docx.pdf\" target=\"_blank\" rel=\"noopener\">Download<\/a> or <a title=\"New Client Information\" href=\"https:\/\/hopeinhealingfamilyservices.com\/?page_id=558\">Fill out online<\/a><\/p>\n<h3>New Client Appointments<\/h3>\n<p>If you wish to schedule an appointment, please first download the session fees, referral form and new client information sheet. If you are referring yourself for counseling, just put &#8220;SELF&#8221; as referral source. Once you have reviewed and filled out the forms, you can complete the contact form below and upload them to our therapist. We will review the forms and contact you to schedule an intake.<\/p>\n<h3>Contact Us<\/h3>\n<div class=\"forminator-ui forminator-custom-form forminator-custom-form-535 forminator-design--default  forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-535\" data-uid=\"69e73cfe02b93\"><br\/><\/div><form\n\t\t\t\tid=\"forminator-module-535\"\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-535 forminator-design--default  forminator_ajax\"\n\t\t\t\tmethod=\"post\"\n\t\t\t\tdata-forminator-render=\"0\"\n\t\t\t\tdata-form-id=\"535\"\n\t\t\t\t\n\t\t\t\tdata-design=\"default\"\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\tdata-grid=\"open\"\n\t\t\t\tenctype=\"multipart\/form-data\"\n\t\t\t\t\n\t\t\t\tstyle=\"display: none;\"\n\t\t\t\t\n\t\t\t\tdata-uid=\"69e73cfe02b93\"\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div class=\"forminator-row\"><div id=\"name-1\" class=\"forminator-field-name forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-1_69e73cfe02b93\" id=\"forminator-field-name-1_69e73cfe02b93-label\" class=\"forminator-label\">First Name <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-1\" value=\"\" placeholder=\"E.g. John\" id=\"forminator-field-name-1_69e73cfe02b93\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" \/><\/div><\/div><div id=\"name-2\" class=\"forminator-field-name forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-2_69e73cfe02b93\" id=\"forminator-field-name-2_69e73cfe02b93-label\" class=\"forminator-label\">Last Name<\/label><input type=\"text\" name=\"name-2\" value=\"\" placeholder=\"E.g. John Doe\" id=\"forminator-field-name-2_69e73cfe02b93\" class=\"forminator-input forminator-name--field\" aria-required=\"false\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"email-1\" class=\"forminator-field-email forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-1_69e73cfe02b93\" id=\"forminator-field-email-1_69e73cfe02b93-label\" class=\"forminator-label\">Email Address <span class=\"forminator-required\">*<\/span><\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"E.g. john@doe.com\" id=\"forminator-field-email-1_69e73cfe02b93\" class=\"forminator-input forminator-email--field\" data-required=\"true\" aria-required=\"true\" \/><\/div><\/div><div id=\"phone-1\" class=\"forminator-field-phone forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-1_69e73cfe02b93\" id=\"forminator-field-phone-1_69e73cfe02b93-label\" class=\"forminator-label\">Phone Number<\/label><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"E.g. +1 3004005000\" id=\"forminator-field-phone-1_69e73cfe02b93\" class=\"forminator-input forminator-field--phone\" data-required=\"\" aria-required=\"false\" autocomplete=\"off\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-1\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-1_69e73cfe02b93\" id=\"forminator-field-textarea-1_69e73cfe02b93-label\" class=\"forminator-label\">Message<\/label><textarea name=\"textarea-1\" placeholder=\"Enter your message...\" id=\"forminator-field-textarea-1_69e73cfe02b93\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" maxlength=\"180\" ><\/textarea><span id=\"forminator-field-textarea-1_69e73cfe02b93-description\" class=\"forminator-description\"><span data-limit=\"180\" data-type=\"characters\">0 \/ 180<\/span><\/span><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-1\" class=\"forminator-field-checkbox forminator-col forminator-col-12 \"><div role=\"group\" class=\"forminator-field required\" aria-labelledby=\"forminator-checkbox-group-69e73cfe02b93-label\"><span id=\"forminator-checkbox-group-69e73cfe02b93-label\" class=\"forminator-label\">I understand the Session Fees <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-checkbox-1-1-69e73cfe02b93-label\" for=\"forminator-field-checkbox-1-1-69e73cfe02b93\" class=\"forminator-checkbox\" title=\"Yes\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Yes\" id=\"forminator-field-checkbox-1-1-69e73cfe02b93\" aria-labelledby=\"forminator-field-checkbox-1-1-69e73cfe02b93-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Yes<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"upload-2\" class=\"forminator-field-upload forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-upload-2_69e73cfe02b93\" id=\"forminator-field-upload-2_69e73cfe02b93-label\" class=\"forminator-label\">Intake Form - Upload file<\/label><div class=\"forminator-file-upload \" data-element=\"upload-2_69e73cfe02b93\"><input type=\"file\" name=\"upload-2\" id=\"forminator-field-upload-2_69e73cfe02b93\" class=\"forminator-input-file\" accept=\".jpg,.jpeg,.jpe,.gif,.png,.bmp,.tiff,.tif,.webp,.ico,.heic,.asf,.asx,.wmv,.wmx,.wm,.avi,.divx,.flv,.mov,.qt,.mpeg,.mpg,.mpe,.mp4,.m4v,.ogv,.webm,.mkv,.3gp,.3gpp,.3g2,.3gp2,.txt,.asc,.c,.cc,.h,.srt,.csv,.tsv,.ics,.rtx,.css,.htm,.html,.vtt,.dfxp,.mp3,.m4a,.m4b,.aac,.ra,.ram,.wav,.ogg,.oga,.flac,.mid,.midi,.wma,.wax,.mka,.rtf,.js,.pdf,.class,.tar,.zip,.gz,.gzip,.rar,.7z,.psd,.xcf,.doc,.pot,.pps,.ppt,.wri,.xla,.xls,.xlt,.xlw,.mdb,.mpp,.docx,.docm,.dotx,.dotm,.xlsx,.xlsm,.xlsb,.xltx,.xltm,.xlam,.pptx,.pptm,.ppsx,.ppsm,.potx,.potm,.ppam,.sldx,.sldm,.onetoc,.onetoc2,.onetmp,.onepkg,.oxps,.xps,.odt,.odp,.ods,.odg,.odc,.odb,.odf,.wp,.wpd,.key,.numbers,.pages\"><button id=\"forminator-field-upload-2_69e73cfe02b93_button\" class=\"forminator-button forminator-button-upload\" data-id=\"forminator-field-upload-2_69e73cfe02b93\">Choose File<\/button><span data-empty-text=\"No file chosen\">No file chosen<\/span><button class=\"forminator-button-delete\" style=\"display: none;\"><i class=\"forminator-icon-close\" aria-hidden=\"true\"><\/i><span class=\"forminator-screen-reader-only\">Delete uploaded file<\/span><\/button><\/div><\/div><\/div><div id=\"upload-1\" class=\"forminator-field-upload forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-upload-1_69e73cfe02b93\" id=\"forminator-field-upload-1_69e73cfe02b93-label\" class=\"forminator-label\">Insurance Card - Upload file<\/label><div class=\"forminator-file-upload \" data-element=\"upload-1_69e73cfe02b93\"><input type=\"file\" name=\"upload-1\" id=\"forminator-field-upload-1_69e73cfe02b93\" class=\"forminator-input-file\" accept=\".jpg,.jpeg,.jpe,.gif,.png,.bmp,.tiff,.tif,.webp,.ico,.heic,.asf,.asx,.wmv,.wmx,.wm,.avi,.divx,.flv,.mov,.qt,.mpeg,.mpg,.mpe,.mp4,.m4v,.ogv,.webm,.mkv,.3gp,.3gpp,.3g2,.3gp2,.txt,.asc,.c,.cc,.h,.srt,.csv,.tsv,.ics,.rtx,.css,.htm,.html,.vtt,.dfxp,.mp3,.m4a,.m4b,.aac,.ra,.ram,.wav,.ogg,.oga,.flac,.mid,.midi,.wma,.wax,.mka,.rtf,.js,.pdf,.class,.tar,.zip,.gz,.gzip,.rar,.7z,.psd,.xcf,.doc,.pot,.pps,.ppt,.wri,.xla,.xls,.xlt,.xlw,.mdb,.mpp,.docx,.docm,.dotx,.dotm,.xlsx,.xlsm,.xlsb,.xltx,.xltm,.xlam,.pptx,.pptm,.ppsx,.ppsm,.potx,.potm,.ppam,.sldx,.sldm,.onetoc,.onetoc2,.onetmp,.onepkg,.oxps,.xps,.odt,.odp,.ods,.odg,.odc,.odb,.odf,.wp,.wpd,.key,.numbers,.pages\"><button id=\"forminator-field-upload-1_69e73cfe02b93_button\" class=\"forminator-button forminator-button-upload\" data-id=\"forminator-field-upload-1_69e73cfe02b93\">Choose File<\/button><span data-empty-text=\"No file chosen\">No file chosen<\/span><button class=\"forminator-button-delete\" style=\"display: none;\"><i class=\"forminator-icon-close\" aria-hidden=\"true\"><\/i><span class=\"forminator-screen-reader-only\">Delete uploaded file<\/span><\/button><\/div><\/div><\/div><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><div class=\"forminator-row forminator-row-last\"><div class=\"forminator-col\"><div class=\"forminator-field\"><button class=\"forminator-button forminator-button-submit\">Send Message<\/button><\/div><\/div><\/div><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"dabb0c46c8\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F68\" \/><input type=\"hidden\" name=\"form_id\" value=\"535\"><input type=\"hidden\" name=\"page_id\" value=\"68\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/hopeinhealingfamilyservices.com\/?page_id=68\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><\/form>\n<p><a href=\"https:\/\/hopeinhealingfamilyservices.com\/\">Back Home<\/a><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Contact us by phone, email or through our contact form. If you are an existing patient, you can log into your account by visiting hopeinhealing.theraplatform.com Hope In Healing Family Services, PLLC Phone: 252-495-0554 Email: office@hopeinhealingfamilyservices.com Forms Session Fees &#8211; Download Referral Form &#8211; Download New Client Information &#8211; Download or Fill out online New Client &hellip; <a href=\"https:\/\/hopeinhealingfamilyservices.com\/?page_id=68\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Contact Us<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/hopeinhealingfamilyservices.com\/index.php?rest_route=\/wp\/v2\/pages\/68"}],"collection":[{"href":"https:\/\/hopeinhealingfamilyservices.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/hopeinhealingfamilyservices.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/hopeinhealingfamilyservices.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/hopeinhealingfamilyservices.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=68"}],"version-history":[{"count":7,"href":"https:\/\/hopeinhealingfamilyservices.com\/index.php?rest_route=\/wp\/v2\/pages\/68\/revisions"}],"predecessor-version":[{"id":553,"href":"https:\/\/hopeinhealingfamilyservices.com\/index.php?rest_route=\/wp\/v2\/pages\/68\/revisions\/553"}],"wp:attachment":[{"href":"https:\/\/hopeinhealingfamilyservices.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=68"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}