Make a Payment - Atlanta Counseling Center

If you would like to make a payment for services rendered, please provide the information requested below. A receipt for payment will be emailed to you. If you have any questions or difficulty making a payment, do not hesitate to call the front office at 770-396-0232, ext. 0, Monday through Thursday from 9am-12pm.

"*" indicates required fields

Client Name*

First Last

Email (for confirmation)*

Therapist*

Date(s) of Session(s)*

Amount*

Total

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Credit Card*