Intake Form

Intake Form

THE OAKS CHRISTIAN FAMILY SERVICES

New Client Intake Form

Thank you for taking this step. Your answers help us serve you well and match you with the right coach or counselor.

"He heals the brokenhearted and binds up their wounds."
Psalm 147:3
Intake Form

Personal information

Services Requested

I am seeking support for

Select all that apply

Your Situation

Select all that apply

Wellness & Safety Check

Your answers are held in complete confidence and help us match you with the best support. Please be as honest as you're able.

Session Fees & Sliding Scale

We believe financial hardship should never stand between you and healing. Our standard session rate is $125. Use the slider below to select a rate that honors your current season. No documentation is required — we trust you.

Choose Your Session Rate

Your selected session fee

Billed per 50-min session

$50 / session

Your selected session fee

Billed per 50-min session

$55 / session

Your selected session fee

Billed per 50-min session

$60 / session

Your selected session fee

Billed per 50-min session

$65 / session

Your selected session fee

Billed per 50-min session

$70 / session

Your selected session fee

Billed per 50-min session

$75 / session

Your selected session fee

Billed per 50-min session

$80 / session

Your selected session fee

Billed per 50-min session

$85 / session

Your selected session fee

Billed per 50-min session

$90 / session

Your selected session fee

Billed per 50-min session

$95 / session

Your selected session fee

Billed per 50-min session

$100 / session

Your selected session fee

Billed per 50-min session

$105 / session

Your selected session fee

Billed per 50-min session

$110 / session

Your selected session fee

Billed per 50-min session

$115 / session

Your selected session fee

Billed per 50-min session

$120 / session

Your selected session fee

Billed per 50-min session

$125 / session

Your selected session fee

Billed per 50-min session

$130 / session

Your selected session fee

Billed per 50-min session

$135 / session

Your selected session fee

Billed per 50-min session

$140 / session

Your selected session fee

Billed per 50-min session

$145 / session

Your selected session fee

Billed per 50-min session

$150 / session

Your selected session fee

Billed per 50-min session

$155 / session

Your selected session fee

Billed per 50-min session

$160 / session

Your selected session fee

Billed per 50-min session

$165 / session

Your selected session fee

Billed per 50-min session

$170 / session

Your selected session fee

Billed per 50-min session

$175 / session

Your selected session fee

Billed per 50-min session

$180 / session

Your selected session fee

Billed per 50-min session

$185 / session

Your selected session fee

Billed per 50-min session

$190 / session

Your selected session fee

Billed per 50-min session

$195 / session

Your selected session fee

Billed per 50-min session

$200 / session

Final Step