Client Counseling Forms
Welcome to The Balm of Gilead Ministries Counseling Center. We’re so glad you’re here. Our heart is to walk with you on a Christ-centered journey of hope, healing, and restoration.
Counseling Forms
Below you will find the forms that may be required as part of your counseling journey. Please complete the forms that your counselor has instructed you to fill out.
Important Information:
Click the button links below to begin completing your forms.
Please select only the forms your counselor has requested.
Counseling Forms
Below you will find the forms that may be required as part of your counseling journey. Please complete the forms that your counselor has instructed you to fill out.
Important Information:
- Each link will take you directly to the form in Adobe Sign.
- Your form is not complete until you enter your email address at the end of the process.
- Once submitted, your completed form will be securely sent to our office.
Click the button links below to begin completing your forms.
Please select only the forms your counselor has requested.
Counseling Fees & Payment Options
We are a Christ-centered, sliding-scale counseling ministry. Session donations are based on combined household income and are offered on the honor system.
Session Rates (60 Minutes)
Session Rates (60 Minutes)
|
Combined Annual
Less than $50,000 annually $50,000 to $75,000 annually $75,000 to $100,00 annually
$100,000 to $150,000 annually $150,000 and over |
Individual
$40
$55 $75 $100 $125 |
Couples/Pre Marital/Marriage
$50
$65 $85 $110 $125 |
Credit/Debit Card Rates (Processing Fees)
|
Individual (Card)
$42
$57.50 $78 $104 $130 |
Couples/Pre Marital/Marriage (Card)
$52
$68 $88 $114.50 $130 |
Payment Policy
All sessions are to be paid in advance of your scheduled appointment. This allows us to focus fully on your care without managing payments during or after your appointment.
Payment Options
Zelle – no additional fee
Venmo – no additional fee
Credit/Debit Card (Square) – processing fee included in rates above. When paying with a card please make sure you include the processing fee.
Payment Policy
All sessions are to be paid in advance of your scheduled appointment. This allows us to focus fully on your care without managing payments during or after your appointment.
Payment Options
Zelle – no additional fee
Venmo – no additional fee
Credit/Debit Card (Square) – processing fee included in rates above. When paying with a card please make sure you include the processing fee.
Financial Hardship
Our heart at The Balm of Gilead Ministries is to make Christ-centered, professional counseling accessible to all.
If you are experiencing financial hardship, please contact our office. We are willing to prayerfully consider adjusted rates when needed.
Our heart at The Balm of Gilead Ministries is to make Christ-centered, professional counseling accessible to all.
If you are experiencing financial hardship, please contact our office. We are willing to prayerfully consider adjusted rates when needed.