IMPACT Family Counseling
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Outpatient Counseling

Counseling Intake Form

The IMPACT Outpatient Counseling Program offers private therapy services to clients based on a sliding fee scale. Examples of sliding scale fees: total annual household income of $15,000 - $20,000 would cost $20 per session; $20,001 - $25,000 would cost $25 per session…

Individual, family, couple, and youth counseling is available by appointment only.

IMPACT has licensed experienced and professional therapists who are dedicated and motivated to improving the quality of life for our clients. We are available for day, afternoon, and evening appointments.

IMPACT provides a variety of counseling services.
  • Marriage/ Couples Counseling
  • Family Counseling
  • Conflict Resolution
  • Grief
  • Divorce Adjustment
  • Self-esteem issues
  • Depression
  • Anxiety
  • Spiritual Concerns

To schedule an appointment
, please fill out the Intake Form here and click "submit" at the end of the form.  You may also download an a form here and return it to us by mail or fax. Once we have received your completed intake form, we will contact you within 24 hours to schedule your appointment.  Contact us for more information or questions.

About Us

Staff
Executive Board
Junior Board
Employment
Annual Reports
IMPACT Newsletters

Programs and Services

Outpatient Counseling
Relationships that Matter
Mentoring
Anger Management
Family Strengthening
Fatherhood
Successful Schools
Cribs for Kids

Contact

Contact Us
Directions
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1000 24th Street South, Birmingham, AL 35205  l 205-916-0123