Digital Christian Teletherapy with Grace Flow Counseling

Grace counseling online

Grace Counseling Online - Client Portal

Welcome Back

Demo: [email protected] / demo123

New to Grace Counseling?

New Client Intake Form

Please complete this form to begin your counseling journey with Grace Counseling Online

Personal Information

First Name *

Last Name *

Date of Birth *

Phone Number *

Email Address *

Home Address

Emergency Contact Name

Emergency Contact Phone

Medical Information

Current Medications *

Medication Allergies

Primary Care Physician

Mental Health History

Have you seen a counselor, therapist, or psychiatrist in the last year? *

Yes No

Please provide details about your recent counseling experience

Have you ever been hospitalized for mental health reasons?

Yes No

What brings you to counseling today? *

Current stress level (1-10 scale) *

Payment & Consent

Payment Information

Grace Counseling Online operates on a cash-pay basis. We do not bill insurance directly.

Payment Method: Cash App

Cash App: $markoreillysr

Session fees are due at the time of service. Payment details will be provided after your appointment is scheduled.

I consent to counseling treatment and understand that all information shared is confidential *

I consent to telehealth counseling sessions when appropriate

Already have an account?

Welcome back, John Doe

🎥 Online Counseling Sessions

Join your secure counseling sessions with Grace Counseling Online

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Appointments

Schedule, view, and manage your upcoming counseling sessions and appointments.

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Messages

Communicate securely with your counselor and receive important updates between sessions.

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Billing & Payments

View statements, make payments, and manage your billing information securely.

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Resources

Access helpful resources, worksheets, and materials provided by your counselor.

Grace Counseling Online

Welcome Back

New Client Intake Form

Payment Information

🎥 Online Counseling Sessions

Your Appointments

Counseling Resources

Messages

Billing Information