Intake Form

Joyful greetings District 8 community! We Want To Hear From You! Boris L. Henson Foundation is partnering with Prince George's County District 8 Council Member Edward Burroughs III to create spaces and events that celebrate joy and offer free mental wellness support for individuals, families, and community. Tell us who you are and let us know what activities that you want to participate in. We will use your feedback to design the programs to meet your needs and interests. Thank you in advance!
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Currently, do you have medical insurance?
If you do not have an insurance at this time please write "None".
Would you be interested in attending individual counseling/therapy sessions if they were fully covered by the Boris L. Henson Foundation?
Would you be interested in attending in-person Integrated Wellness sessions (yoga, sound therapy, art therapy, meditation, etc.)?
Would you be interested in attending group counseling/therapy if they were fully covered the Boris L. Henson Foundation?
If you are open to individual or group counseling/therapeutic services, would you be interested in signing up in the next 30 days?

Confidentiality Disclaimer

Please note that all responses will be kept confidential and will be used only to inform us of topics beneficial to you.