Application to Work With Jamal Jones, LMFT

Thank you for your interest in working with us!

We work with a limited number of individuals and couples who are serious about meaningful, faith-integrated transformation.

Our process is structured, intentional, and designed to help you gain clarity, direction, and lasting results.

Please complete this application thoughtfully.

Your information will be sent to us automatically, and you'll receive an email with your next steps. If you have any questions, feel free to reach out at [email protected]. We look forward to connecting with you!

Full Name *

Phone

*By providing your phone number, you agree to receive text messages from Central Valley Christian Counsel regarding appointments, services, and updates. Message frequency varies. Message and data rates may apply. Reply STOP to opt out.

Email *

Central Valley Christian Counsel is a private-pay counseling practice and does not accept insurance. *

I am specifically seeking private-pay counseling

I understand insurance is not accepted and I am comfortable proceeding

I am looking for insurance-based services

Are you currently experiencing a mental health crisis requiring immediate medical care? *

Yes

What type of support are you seeking? *

Individual Counseling

Couple / Marriage Counseling

Family Counseling

What is your spouse/partner's full name?

What challenge prompted you to seek support at this time? *

What has been weighing on you the most lately? *

If our work together were successful over the next 90 days, what would make this investment feel completely worthwhile? *

On a scale from 1–10, how committed are you to doing the internal work required for meaningful change? *

110

Rate your commitment level

Our process begins with a Private Clarity Intensive ($300). This is a focused, 60-minute session designed to help you gain clarity, identify key patterns, and determine the most appropriate next step. If we determine it is a strong fit to continue working together, we will discuss a structured plan of care aligned with your goals. *

I am ready to move forward with the Private Clarity Intensive

I am open, but would like to learn more

I am not ready to invest at this time

Consent Checkbox

By checking this box, I consent to receive SMS messages from Central Valley Christian Counseling regarding appointment scheduling, appointment reminders, responses to inquiries, and other service-related communications. Message frequency may vary. Message and data rates may apply. Reply STOP to opt out or HELP for help.

By checking this box, I consent to receive marketing and informational SMS messages from Central Valley Christian Counseling, including wellness tips, service updates, event announcements, and special offers. Message frequency may vary. Message and data rates may apply. Reply STOP to opt out or HELP for help.