The fee for counseling at the Life Enrichment Christian Counseling Center is determined by a sliding scale based upon
the total yearly gross earnings per family. We ask for payment at the end of each session. A fee of $25.00
will be added to the fee per session if more than one counselor is present. The fee for phone counseling and phone consultations
will be the same as above.
Please right yes or no next to each entry. Thank you.
Client’s Name (optional): ______________________________________________
Counselor’s Name (required): ___________________________________________
Was the setting appropriate?
there were anything you would change about the counselor or the counseling process it would be: