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Home » Contact Us

Contact Us

Address:
Jewish Family Services of Greenwich
One Holly Hill Lane
Greenwich, CT 06830

Office Hours:
Monday – Thursday: 9:00 am – 5:00 pm
Friday: 9:00 am – 4:00 pm
Evening Hours by appointment

Contact:
Phone: 203-622-1881
Fax: 203-622-1885
Email: mknee@jfsgreenwich.org

Please complete the following form if you are interested in counseling or support groups

Name
First Last
Name of Guardian (if client under 18)
First Last
Email
Phone
Address
Date of Birth
If minor, current school attending
Insurance Company
Insurance Policy #
Secondary Insurance Company (if applicable)
Secondary Insurance Policy #
Emergency Contact Name
Emergency Contact Number
Have you ever been in therapy before?
- Yes
- No
If yes, please explain
Are you currently seeing a psychiatrist for medication management?
- Yes
- No
If so, who?
Is this for a court order or forensic related matter?
- Yes
- No
Have you been hospitalized in the last 3 months?
- Yes
- No
If yes, please explain
Do you own a firearm?
- Yes
- No
Have you thought about harming yourself?
- Yes
- No
Have you thought about harming others?
- Yes
- No
If yes, please explain
Do you have any active substance abuse concerns, or sobriety for less than 3 months?
- Yes
- No
If yes, please explain
Please briefly explain the reason for your visit
How did you hear about JFS of Greenwich?
Are you requesting a specific therapist at JFS of Greenwich?
CAPTCHA

Upcoming Events

March 11, 2021 7:00pm

Re-entering a Changed World led by Betsy Stone

March 15, 2021 6:30pm

Executive Committee Meeting

March 15, 2021 7:30pm

JFS BOARD MEETING

March 22, 2021 12:15pm

JFS HEALING SERVICE

March 26, 2021 10:00am

Pilates with Carly

March 31, 2021 12:00pm

Learn, Listen, and Talk with Fellow Heart Warriors-Lunch and Talk: March 31, 2021 at 12 noon

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Jewish Family Services of Greenwich
One Holly Hill Lane,
Greenwich, CT 06830
(203) 622-1881

About
Programs & Services
Volunteer
Events
Contact Us
Donate

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About
Programs & Services
Volunteer
Events
Contact Us
Donate

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Copyright 2019 | Jewish Family Services of Greenwich