Counseling & Meeting Request

A Place for Guidance, Growth, and Restoration

We believe that maintaining a healthy walk with the Most High includes knowing when to seek guidance, encouragement, prayer, and support. Restoration Center Charlotte provides opportunities for members of the congregation to request meetings with designated counselors and ministry leadership.

Please complete this form to request a meeting. Our administration will review your request and coordinate with the appropriate person to help arrange a meeting.

01Your Information

Full Name

Phone Number

Email Address

Preferred Method of Contact

02Nature of Your Request

What type of meeting are you requesting?

Briefly describe the reason for your meeting.

Please share enough information to help us understand the nature of your request. You do not need to provide every personal detail at this stage.

03Meeting Preferences

Who would you prefer to meet with?

Please understand that your preferred counselor may not always be available. Administration will help coordinate your request with the appropriate person.

Preferred Meeting Format

Preferred Days

Preferred Time

Is this a one-time meeting or ongoing support?

Have you previously met with an RCC counselor regarding this matter?

04Additional Information

Is there anything else you would like administration to know when coordinating your meeting? (Optional)

05Response Time & Acknowledgment

Please Allow Up to 48 Hours for a Response

Thank you for reaching out to Restoration Center Charlotte. Please allow our administration up to 48 hours to review your request and respond regarding the next steps for scheduling.

Submitting this form does not guarantee an immediate appointment. Meeting availability depends on counselor schedules and the nature of the request.

Please do not use this form to report an emergency, an immediate threat to someone’s safety, or a situation requiring urgent intervention. In an emergency, call 911 or contact the appropriate emergency services.

I understand that administration may take up to 48 hours to respond to my meeting request.I understand that submitting this form is a request and does not confirm an appointment.I understand that I should share only the information necessary to coordinate my meeting and that sensitive information should be discussed directly with the appropriate counselor.

Thank you for allowing Restoration Center Charlotte to walk alongside you in your journey of faith, growth, and restoration.