Marriage Counseling Contact Form

SBNY is a New York state registered nonprofit Islamic social services organization. All services are provided free of charge, solely for the benefit of the community.

PRIVACY AND CONFIDENTIALTY DISCLOSURE

SBNY treats all information obtained from this form and all other communication with the highest standards of privacy and confidentiality.  SBNY will never share any of your information with any party without your prior consent.  SBNY commits to uphold the golden values taught by the Messenger of Allah, peace and blessings be upon him, in this regard, “Meetings (communications) are confidential.” (Abu Dawud, 4869)

ALL FIELDS ARE REQUIRED.

    Which language would you like counseling in? Select all that apply?

    Best method of contact
    PhoneEmail

    Would you like in-person or over-the-phone counseling?
    In-personOver-the-phone

    Best method of contact?
    PhoneEmail

    Spouse Language Preference?
    EnglishArabicBanglaUrduother

    Letter of Acknowledgement for SBNY Marriage Care-Line (MCL)

    In order to receive counseling services which are provided at no cost from MCL in helping resolve my marital problems, I hereby acknowledge that I have read, understand, and agree to the following.

    When expressing myself during the session, I will abide by the etiquettes listed below:

    I will use easy, clear, explicit and concise language to express myself

    I will state my point and mention only important issues related to my marriage instead of justifying and demanding.

    I will refrain from:
    • Unnecessary and unrelated explanations
    • Cursing
    • Rude, offensive and obscene language
    • Shouting
    • Interrupting the other
    • Repeating my points over and over

    I will try, to the best of my ability, to adhere and act upon the advices/suggestions of the scholars with wholeheartedness.

    I will respect my spouse's honor and dignity when expressing myself.

    There is no compulsion upon me from any individual or organization in seeking counseling. I am seeking counseling at my free will.

    I indemnify MCL from all liability in any court of law regarding any issues that may arise from the services that ensue from the counseling services.

    If these etiquettes are not honored, the Counselor Imam holds the right to terminate the session.

    By clicking on [Acknowledge and Submit] you acknowledge that you have read, understood, and agreed.