
LET’S CONNECT
COMPLETE the FORM
for your
NO-COST
NO OBLIGATION
15 minute CONSULTATION
with
Lea Frances-Poll
clinical mental health counselor
This form goes to an email address that is NOT monitored for crisis situations.
If you are in need of immediate support for thoughts of suicide or self-harm or harm to others,
please call 911 or the Behavioral Health Access Center at 435-251-4480.