Life Enrichment Christian Counseling Center
Please fill out and forward to your counselor

 
 
 

The fee for counseling at the Life Enrichment Christian Counseling Center is determined by a sliding scale based upon the total yearly gross earinings per family.

We ask for payment at the end of each session. As indicated by the Life Enrichments’ “Guidelines” for most people a significant portion or the cost of counseling is covered by ones’ medical coverage. Please bring a major medical claim form filled out and we will complete our portion and forward it on to your provider. They will reimburse you directly accordingly.

A fee of $25.00 will be added to the fee per session if more than one counselor is present.

Thank you.

CLIENT EVALUATION

Please right yes or no next to each entry. Thank you.

Client’s Name (optional): ______________________________________________

Counselor’s Name (required): ___________________________________________

Biblical:

Fair:

Practical:

Too Fast:

Too Slow:

Compassionate:

Listening:

Indifferent:

Caring:

Proud:

Knowledgeable:

Understanding:

Dogmatic:

Personal:

Was the setting appropriate?

If there were anything you would change about the counselor or the counseling process it would be: