Contact & Booking

Basic Contact Information

First Name*

Last Name*

Email Address*

Phone Number

Preferred Contact Method* (Click the Dropdown)
EmailPhoneEither

Church / Organization Details

Church or Organization Name*

City

State / Province

Zip Code

Role or Title* (Pastor, Director, Staff, etc.)

Denomination or Affiliation

Service Interest

Which services are you interested in?*

On-Call ConsultationLeadership TrainingCounseling Ministry PlanningChurch Mental Health Training (workshops, seminars, retreats)Live Event / Conference SpeakingCustom Training or Consultation

Preferred Format* (Click the Dropdown)
In-personVirtualHybrid / Either

Primary Audience (you can select more than one)

Pastors and clergyChurch staffLay leaders / volunteersCongregation-wideNonprofit or community partners

Estimated Group Size (Click the Dropdown)
Under 2525–5051–100100+

Preferred Date or Date Range

How many hours of training are you considering? (Click the Dropdown)
90-minute sessionHalf-day (3 hours)Full-day (5–6 hours)Multi-session seriesNot sure, please recommend

Briefly describe what you are hoping this training or consultation will address.*

Budget and Decision Timeline

Budget Range (optional) (Click the Dropdown)
Not sure yetUnder $1,000$1,000–$3,000$3,000–$5,000Over $5,000

Decision Timeline* (Click the Dropdown)
Within 2 weeksWithin 1–2 monthsLonger than 2 monthsJust exploring options

How did you hear about Church Mental Health Training?

I am open to receiving occasional updates about trainings and resources.

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Primary Contact

First Name*

Last Name*

Email Address*

Phone Number

Title / Role* (Bishop, Superintendent, Director, etc.)

Denomination / Organization Details

Denomination or Network Name*

Department or Division (if applicable)

Website

Regions Served (for example: Southeast US, National, Global)

Scope of Request

What are you interested in exploring?*

Clergy mental health training for your district / conferenceLeadership training for pastors and staffCounseling ministry planning across multiple churchesKeynote / plenary sessions for denominational eventsOngoing consultation or partnershipCustom curriculum or certificate program

Estimated number of churches or sites involved

Estimated total number of participants

Format and Timeframe

Preferred delivery format* (Click the Dropdown)
In-person regional gatheringsVirtual cohortsBlended modelNot sure yet

Desired timeline or event window

Goals and Outcomes

What are your main goals for this training or partnership?* (Click the Dropdown)

Budget and Decision Process

Approximate budget range (if known) (Click the Dropdown)
Not sure yetUnder $5,000$5,000–$10,000$10,000–$25,000Over $25,000

Who will be involved in the decision?* (Click the Dropdown)
I am the primary decision makerI am gathering information for a committeeI am recommending options to leadership

Next Steps

Preferred way to connect for next steps* (Click the Dropdown)
Email follow-up30-minute discovery call

Any additional details or questions

Please send me more information about denominational or enterprise-level partnerships.

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Your name

Your email

Your number

Subject

Your message (optional)

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