New Reflections Counseling, Inc.
Professional Christian Counseling
937-776-7290
If you have any questions you may call one of the numbers or use our
online contact form
. All correspondence is held in strict confidence.
Home
Counseling
Our Counselors
Counselor Evaluation
Locations
Dayton - Montgomery County - Centerville
About
Contact Us
Login
Christian Counselors
>
Contact
>
Contact
Contact Us
When you contact NRC we will attempt to respond within 4 business hours. However, we might need until the next business day. Filling out this contact form will speed up the process of us contacting you and scheduling an appointment.
All correspondence is held in strict confidence for internal use only (not sold, traded, or given away).
*
means this information is required; all other information is optional but helps us improve our services.
Contact Reason:
*
I want to
<- Select One ->
ask a question about counseling services
schedule a face-to-face appointment
schedule a video or phone appointment
reschedule or cancel my appointment
contact a specific person
subscribe to daily reflections
learn more about work opportunities
receive technical assistance
contact for some other reason
send this message to:
?
If you want to reach a specific counselor, select them here. Select a reason first.
Contact Message:
*
About You
First Name:
*
?
Enter at least 1 character
Last Name:
*
?
Enter at least 2 characters
Email:
*
<- Select One ->
Home
Work
Other
Try Me Here First
Try Me Here Second
Try Me Here Third
Do Not Contact Me Here
?
An email address is always required. Select a preference for how we should attempt to contact you.
Phone:
<- Select One ->
Home
Work
Cell
Other
Try Me Here First
Try Me Here Second
Try Me Here Third
Do Not Contact Me Here
?
Select a preference for how we should attempt to contact you.
Address:
Street 1:
Try Me Here First
Try Me Here Second
Try Me Here Third
Do Not Contact Me Here
?
Select a preference for how we should attempt to contact you.
Street 2:
City:
State:
Zip:
Gender:
Male
Female
Unspecified
How did you find us?
Appointment Preferences
Reason for Scheduling (primary reason):
<- Select One ->
Spiritual > Growth (closer to God)
Spiritual > Condemnation (guilt, fear of hell)
Spiritual > Faith (belief, crisis, trust)
Spiritual > Purpose (meaning, calling, gifting)
Spiritual > Attack (demonic, satan)
Spiritual > Spiritual (other)
Personal > Abuse: Emotional (verbal, spiritual)
Personal > Abuse: Physical (violence)
Personal > Abuse: Sexual (incest, molestation)
Personal > Abuse: Sexual (rape, date-rape)
Personal > Addiction: Eating Disorder (food)
Personal > Addiction: Electronic (video, computer, internet)
Personal > Addiction: Sexual (pornography, sex, fetish)
Personal > Addiction: Substance (drugs, alcohol)
Personal > Addiction: Other
Personal > Adjusting to Loss: Abortion
Personal > Adjusting to Loss: Break Up (dating, relationship)
Personal > Adjusting to Loss: Infertility
Personal > Adjusting to Loss: Death
Personal > Adjusting to Loss: Divorce
Personal > Adjusting to Loss: Miscarriage
Personal > Adjusting to Loss: Other
Personal > Adjusting to Getting Older
Personal > Adjusting to Moving (culture, shock, deployment)
Personal > Anger (self-control, temper, guilt)
Personal > Anxiety (fear, worry)
Personal > Anxiety (panic attacks, nightmares, flashbacks)
Personal > Anxiety: PTSD (post-traumatic-stress-disorder)
Personal > Anxiety: DID (dissociative-identity-disorder)
Personal > Anxiety: OCD (obsessive-compulsive-disorder)
Personal > Boundaries (setting limits, people-pleasing)
Personal > Depression
Personal > Depression: Loneliness (isolated, disconnected)
Personal > Depression: Suicidal
Personal > Forgiveness (self, bitterness)
Personal > Goals (life-coaching, plan, transition, manage change)
Personal > Growth: Emotional
Personal > Healing Emotional Wounds
Personal > Honesty (stop lying)
Personal > Identity (knowing self, contentment, self-acceptance)
Personal > Identity: Manhood (be a better man, husband, father)
Personal > Identity: Womanhood (be a better woman, wife, mother)
Personal > Mental Illness (diagnosis, medication, psychosis)
Personal > Mood Swings (irritability, sensitivity)
Personal > Neglect (abandonment, childhood wounds)
Personal > Numbness (cannot feel, empty, isolated, disconnected)
Personal > Self-Harm (cutting, burning, mutilation)
Personal > Self-Worth (low self-esteem, insecurity, shame, self-hatred)
Personal > Sexuality (unwanted thoughts or behaviors)
Personal > Singleness Issues
Personal > Stress (overwhelmed, management)
Personal > Work: Career Choices
Personal > Work: Job Loss
Personal > Coping with People (their problem, dysfunction, sin)
Personal > Trauma (other)
Personal > Personal (other)
Relational > Dating
Relational > Dating: Get Married or Break Up?
Relational > Dating: Pre-marital (pre-engagement)
Relational > Boundaries (separation, safety)
Relational > Boundaries (between couple and other people or things)
Relational > Conflict Resolution
Relational > Communication
Relational > Intimacy: Emotional (interest, pursuing, engaging)
Relational > Intimacy: Sexual (passion, love-making)
Relational > Intimacy: Time (doing, companionship, playing)
Relational > Betrayal (affair, dishonesty, cheating, infidelity, unfaithful)
Relational > Trust Issues
Relational > Reconciliation (repentence, forgiveness, negotiation)
Relational > Divorce
Relational > Remarriage
Relational > Workplace (boss, coworkers, employer, employee)
Relational > Family (adult conflict)
Relational > Family (child maturity)
Relational > Family (parenting)
Relational > Relational (other)
Reason for Scheduling (second reason):
<- Select One ->
Spiritual > Growth (closer to God)
Spiritual > Condemnation (guilt, fear of hell)
Spiritual > Faith (belief, crisis, trust)
Spiritual > Purpose (meaning, calling, gifting)
Spiritual > Attack (demonic, satan)
Spiritual > Spiritual (other)
Personal > Abuse: Emotional (verbal, spiritual)
Personal > Abuse: Physical (violence)
Personal > Abuse: Sexual (incest, molestation)
Personal > Abuse: Sexual (rape, date-rape)
Personal > Addiction: Eating Disorder (food)
Personal > Addiction: Electronic (video, computer, internet)
Personal > Addiction: Sexual (pornography, sex, fetish)
Personal > Addiction: Substance (drugs, alcohol)
Personal > Addiction: Other
Personal > Adjusting to Loss: Abortion
Personal > Adjusting to Loss: Break Up (dating, relationship)
Personal > Adjusting to Loss: Infertility
Personal > Adjusting to Loss: Death
Personal > Adjusting to Loss: Divorce
Personal > Adjusting to Loss: Miscarriage
Personal > Adjusting to Loss: Other
Personal > Adjusting to Getting Older
Personal > Adjusting to Moving (culture, shock, deployment)
Personal > Anger (self-control, temper, guilt)
Personal > Anxiety (fear, worry)
Personal > Anxiety (panic attacks, nightmares, flashbacks)
Personal > Anxiety: PTSD (post-traumatic-stress-disorder)
Personal > Anxiety: DID (dissociative-identity-disorder)
Personal > Anxiety: OCD (obsessive-compulsive-disorder)
Personal > Boundaries (setting limits, people-pleasing)
Personal > Depression
Personal > Depression: Loneliness (isolated, disconnected)
Personal > Depression: Suicidal
Personal > Forgiveness (self, bitterness)
Personal > Goals (life-coaching, plan, transition, manage change)
Personal > Growth: Emotional
Personal > Healing Emotional Wounds
Personal > Honesty (stop lying)
Personal > Identity (knowing self, contentment, self-acceptance)
Personal > Identity: Manhood (be a better man, husband, father)
Personal > Identity: Womanhood (be a better woman, wife, mother)
Personal > Mental Illness (diagnosis, medication, psychosis)
Personal > Mood Swings (irritability, sensitivity)
Personal > Neglect (abandonment, childhood wounds)
Personal > Numbness (cannot feel, empty, isolated, disconnected)
Personal > Self-Harm (cutting, burning, mutilation)
Personal > Self-Worth (low self-esteem, insecurity, shame, self-hatred)
Personal > Sexuality (unwanted thoughts or behaviors)
Personal > Singleness Issues
Personal > Stress (overwhelmed, management)
Personal > Work: Career Choices
Personal > Work: Job Loss
Personal > Coping with People (their problem, dysfunction, sin)
Personal > Trauma (other)
Personal > Personal (other)
Relational > Dating
Relational > Dating: Get Married or Break Up?
Relational > Dating: Pre-marital (pre-engagement)
Relational > Boundaries (separation, safety)
Relational > Boundaries (between couple and other people or things)
Relational > Conflict Resolution
Relational > Communication
Relational > Intimacy: Emotional (interest, pursuing, engaging)
Relational > Intimacy: Sexual (passion, love-making)
Relational > Intimacy: Time (doing, companionship, playing)
Relational > Betrayal (affair, dishonesty, cheating, infidelity, unfaithful)
Relational > Trust Issues
Relational > Reconciliation (repentence, forgiveness, negotiation)
Relational > Divorce
Relational > Remarriage
Relational > Workplace (boss, coworkers, employer, employee)
Relational > Family (adult conflict)
Relational > Family (child maturity)
Relational > Family (parenting)
Relational > Relational (other)
Reason for Scheduling (third reason):
<- Select One ->
Spiritual > Growth (closer to God)
Spiritual > Condemnation (guilt, fear of hell)
Spiritual > Faith (belief, crisis, trust)
Spiritual > Purpose (meaning, calling, gifting)
Spiritual > Attack (demonic, satan)
Spiritual > Spiritual (other)
Personal > Abuse: Emotional (verbal, spiritual)
Personal > Abuse: Physical (violence)
Personal > Abuse: Sexual (incest, molestation)
Personal > Abuse: Sexual (rape, date-rape)
Personal > Addiction: Eating Disorder (food)
Personal > Addiction: Electronic (video, computer, internet)
Personal > Addiction: Sexual (pornography, sex, fetish)
Personal > Addiction: Substance (drugs, alcohol)
Personal > Addiction: Other
Personal > Adjusting to Loss: Abortion
Personal > Adjusting to Loss: Break Up (dating, relationship)
Personal > Adjusting to Loss: Infertility
Personal > Adjusting to Loss: Death
Personal > Adjusting to Loss: Divorce
Personal > Adjusting to Loss: Miscarriage
Personal > Adjusting to Loss: Other
Personal > Adjusting to Getting Older
Personal > Adjusting to Moving (culture, shock, deployment)
Personal > Anger (self-control, temper, guilt)
Personal > Anxiety (fear, worry)
Personal > Anxiety (panic attacks, nightmares, flashbacks)
Personal > Anxiety: PTSD (post-traumatic-stress-disorder)
Personal > Anxiety: DID (dissociative-identity-disorder)
Personal > Anxiety: OCD (obsessive-compulsive-disorder)
Personal > Boundaries (setting limits, people-pleasing)
Personal > Depression
Personal > Depression: Loneliness (isolated, disconnected)
Personal > Depression: Suicidal
Personal > Forgiveness (self, bitterness)
Personal > Goals (life-coaching, plan, transition, manage change)
Personal > Growth: Emotional
Personal > Healing Emotional Wounds
Personal > Honesty (stop lying)
Personal > Identity (knowing self, contentment, self-acceptance)
Personal > Identity: Manhood (be a better man, husband, father)
Personal > Identity: Womanhood (be a better woman, wife, mother)
Personal > Mental Illness (diagnosis, medication, psychosis)
Personal > Mood Swings (irritability, sensitivity)
Personal > Neglect (abandonment, childhood wounds)
Personal > Numbness (cannot feel, empty, isolated, disconnected)
Personal > Self-Harm (cutting, burning, mutilation)
Personal > Self-Worth (low self-esteem, insecurity, shame, self-hatred)
Personal > Sexuality (unwanted thoughts or behaviors)
Personal > Singleness Issues
Personal > Stress (overwhelmed, management)
Personal > Work: Career Choices
Personal > Work: Job Loss
Personal > Coping with People (their problem, dysfunction, sin)
Personal > Trauma (other)
Personal > Personal (other)
Relational > Dating
Relational > Dating: Get Married or Break Up?
Relational > Dating: Pre-marital (pre-engagement)
Relational > Boundaries (separation, safety)
Relational > Boundaries (between couple and other people or things)
Relational > Conflict Resolution
Relational > Communication
Relational > Intimacy: Emotional (interest, pursuing, engaging)
Relational > Intimacy: Sexual (passion, love-making)
Relational > Intimacy: Time (doing, companionship, playing)
Relational > Betrayal (affair, dishonesty, cheating, infidelity, unfaithful)
Relational > Trust Issues
Relational > Reconciliation (repentence, forgiveness, negotiation)
Relational > Divorce
Relational > Remarriage
Relational > Workplace (boss, coworkers, employer, employee)
Relational > Family (adult conflict)
Relational > Family (child maturity)
Relational > Family (parenting)
Relational > Relational (other)
Reason for Scheduling (not listed above):
Counseling Format:
Individual?
Relationship?
Pre-Engagement?
Pre-Marital?
Marriage?
Family?
Group?
Counseling Location/Method:
Face-to-Face Dayton (Centerville)?
Video?
Phone?
Chat?
Email?
No Preference?
Day of Week Availability:
Monday?
Tuesday?
Wednesday?
Thurday?
Friday?
Saturday?
No Preference?
Time of Day Availability:
Morning (8am-12pm)?
Afternoon (12pm-5pm)?
Evening (5pm-9pm)?
No Preference?
Counselor's Gender:
Male?
Female?
No Preference?
Counselor(s) You Prefer To See:
Appointment Date/Time First Choice:
MM/DD/YYYY hh AM|PM (Eastern Standard Time)
Appointment Date/Time Second Choice:
MM/DD/YYYY hh AM|PM (Eastern Standard Time)
Appointment Date/Time Third Choice:
MM/DD/YYYY hh AM|PM (Eastern Standard Time)
After you click Submit Contact, we will send you a confirmation email from our Contact email. We don't regularly monitor this email, so please use this form to contact us. Or, you can use your counselor's direct email.
Submit Contact
  
Copyright © 2003 - 2024
New Reflections Counseling, Inc.
All Rights Reserved.