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Service Request Form

  • Client Information

    Please complete the following section with information about the person for whom services are being sought.
  • *NOTE: In order to access services, you must be a resident of Oklahoma.
  • Services Requested

    *NOTE: Calm Waters is only able to serve those who are experiencing grief/loss related to one of the above.
    *Note: Individual counseling services are available for ages 6+. Children ages 5 years and under will be served through family sessions involving at least one parent/caregiver.
  • Payment

  • Calm Waters staff will contact you after this form and payment is submitted for scheduling.
  • $0.00