Client Guidelines

The Partnership provides subsidies to clients who are uninsured and underinsured (mental health deductible higher than $1000 and/or cannot afford insurance co-payments).   All applicants must provide income eligibility documents and adhere to the client guidelines set forth in this document.  PPC funding is intended to be used for individuals, families or couples experiencing a short term life crisis and not for ongoing therapy or medication management. 

Please anticipate at least two weeks for applications to be approved; each applicant may be required to complete a confidential intake appointment before final approval is granted.  This session will be included in the total number of sessions granted not to exceed 16 if approved.

You will not be charged for the intake appointment regardless of your approval status

Partnership Counselors agree to see clients at a reduced rate with the client co-payment and partnership subsidy totaling $70 per session. The amount of the subsidy and the client co-payment is determined by a recommendation of said counselor and then compared to a standardized sliding scale.

The minimum co-payment required by each client is not to be less than $10 per session

The maximum income level for a household of 5 must not exceed $50,000.  If you feel you have a financial hardship - please contact Rebecca Wells at 828-275-7279 after completing the online application.

The Partnership will match you with an approved counselor based on your difficulty and the location of your home.  If it is more convenient for you to utilize a counselor within your employment/school region please indicate on application in space marked: alternate location for scheduling.

ALL APPLICATIONS WILL BE ANONYMOUSLY REVIEWED AND APPROVED BY A TWO PERSON ADVISORY COMMITTEE OF THE PARTNERSHIP BOARD OF DIRECTORS

YOUR COUNSELOR WILL FILE ALL NECESSARY PAPERWORK FOR REIMBURSEMENT FROM THE PARTNERSHIP.  PAYMENTS WILL GO DIRECTLY TO THE COUNSELOR. 

 Responsibility of the applicant/Client

  • complete the application in its entirety, INCLUDING THE PRE EVALUATION (incomplete applications will delay your request).

  • provide proof of income.

  • CO-PAYMENT's are to be paid TO THE COUNSELOR AT THE TIME OF EACH SESSION.

  • Contact your assigned counselor within 2 weeks of approval letter.

  • NOTIFY THE PARTNERSHIP IMMEDIATELY IF A CHANGE IN COUNSELOR IS DESIRED.  IN THE EVENT THE COUNSELOR IS CHANGED THE SESSIONS WILL BE CARRIED OVER BUT NOT RENEWED TO THE ORIGINAL SESSION AMOUNT.

  • Contact the Partnership immediately IF YOUR FINANCIAL SITUATION CHANGES OR SERVICES OF THE PARTNERSHIP ARE NO LONGER NEEDED OR WANTED THE PARTNERSHIP SHOULD BE NOTIFIED IMMEDIATELY SO THAT FUTURE SUBSIDIES CAN BE ADJUSTED TO ALLOW FOR OTHERS TO APPLY.  

  • complete a post evaluation at the end of your last counseling session and return to your counselor and/or the partnership.  

Up to sixteen sessions will be approved per applicant. Sessions must be completed within 18 months of approval date.  

Services are for short term crisis management and not to be used for ongoing long term therapy or medication management. clients can reapply after a hiatus of one year and a post evaluation was submitted after the last session was completed.

The Partnership for Pastoral Counseling has the right to deny and/or terminate services of any applicant providing misleading information, if contact is not made with the approved counselor within 2 weeks of approval date or misses more than 2 sessions.

 Online Client Application

I have read and agree to adhere to the client guidelines and agree to complete the post evaluation at the end of my therapy plan. *
Name *
Name
Mailing Address *
Mailing Address
Phone *
Phone
Phone we can contact you at.
Age Range *
Gender *
This information is collected to help us secure funding and ensure we are serving a diverse community.
Ex. Christian, Baptist, Presbyterian, None...etc.
Your church will NOT be contacted - this information is collected to help us ensure we are serving a diverse group faith institutions.
If seeking marital counseling - please complete
If insured - please provide Name of Insurance Company, Deductible and Co-Payment information
Are you currently under the care of a counselor? *
If YES - Please indicate reason for seeking services through the Partnership.
If you have been given a source code please enter it here. If not please let us know how you heard about us.
All sources of income - verification of these sources will be requested.
Please rate on a scale of 1-10 1 = No Distress 10 = Very Distressed
Please rate on a scale from 1-10 1 = Coping Very Well 10= Very Little ability to Cope
Please rate on a scale from 1-10 1 = Overall Life Satisfaction Low 10 = Overall Life Satisfaction High
Examples: Drinking, Smoking, Argue, Nervous Stomach, Developed Headaches, Withdrawn, Denial(that nothing is wrong), etc...