
Parental Consent: Parental consent is required for all students 17 and under before services can begin.
Attendance Policy: Since consistent attendance is important, the Let’s Talk powered by Gaggle Therapy team will reach out after one missed session, and two missed sessions without notice may result in removal from the program.
Sessions will be provided as long as funds are available.
Go to this link and complete all of the steps.

Be sure to select Roanoke County Public Schools-Roanoke VA for your district selection.
These videos walk through the registration process in English and instrucciones en Espanol. Once consent paperwork is complete, you will be matched with a therapist and should hear from Gaggle Therapy within 5 business days, to schedule your first session.
Gaggle Intake and Consent Form (English) | Gaggle Intake and Consent Form (Spanish)
If you prefer to complete paper copies of the consent and intake paperwork, please download and fill out the forms.
Completed forms must be returned to: staff@gaggletherapy.com.
If you have any questions email: staff@gaggletherapy.com and cc: jscritchfield@gaggle.net
You will need the following information to register:
Name
Date of Birth
Cell Phone Number for session reminder texts (if applicable)
Reason person is being referred to therapy
Contact information for the person who will serve as a during session Emergency Contact (Parent/Guardian Name, Phone Number, Email)
Client Details
Grade is requested, but if you are not a student, select “other”.
Preferred Language refers to the participant’s preferred language for sessions. Please select accordingly.
Referral Details
Provide any further context on why you would like therapy:
→ Please include any therapist preferences or other important information that will help us match you with the provider who best fits your needs.
Referral Session Communication Options
Who has agreed to receive text messages regarding this Referral
→ Please choose Client + Primary Emergency Contact