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Get Started

  • Welcome to Lifeway Counseling Centers. Please complete the ‘Getting Started’ information form so that our Client Care Coordinator can call you, have an opportunity to learn a little more about your counseling needs, and schedule you for the Lifeway Consulation with a Consultation Expert.
  • Thank you for your interest on the information from LifeWay Counseling Centers! Please fill out the selected form below.
  • It is LifeWay’s policy, and a clinical best practice, that clients who need medication also need to be engaged in therapy for successful outcomes. Our psychiatrists and nurse practitioners treat clients who are in therapy with a LifeWay counselor. Specific conditions such as ADD/ADHD and certain referrals from community therapists can be treated at LifeWay without a LifeWay therapist.
  • Specific conditions such as ADD/ADHD and certain referrals from community therapists can be treated at LifeWay without a LifeWay therapist.
  • Child and adolescent treatment at LW, and a clinical best practice, will always require the participation of one or more primary caregivers. Our goal is to empower parents and children to enjoy a healthy connection so that both will thrive.

Who will be participating in the Counseling ?*

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Age should be more than 18+
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Emergency Contact Information

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Responsible party for payment:

How did You learn about Lifeway Counseling Centers? Check all that apply.

Enter First Name
Enter Last Name
Age should not be more than 18+
Select Gender
Enter Address
Enter City
Select State / Province
Enter Zip code
Enter valid email

Parent or Guardian information

Enter First Name
Enter Last Name
Age should be more than 18+
Select Gender
Enter Address
Enter City
Select State / Province
Enter Zip code
Select any

Emergency Contact Information

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(JPEG or PNG)

Responsible party for payment:

How did You learn about Lifeway Counseling Centers? Check all that apply.

Enter First Name
Enter Last Name
Enter valid DOB
Select Gender
Enter Address
Enter City
Select State / Province
Enter valid email
Select any

Emergency Contact Information

Select any

(JPEG or PNG)

(JPEG or PNG)

Responsible party for payment:

If Marriage/couples, counseling second adult person information

How did You learn about Lifeway Counseling Centers? Check all that apply.

Enter First Name
Enter Last Name
Enter valid DOB
Select Gender
Enter Address
Enter City
Select State / Province
Enter valid email
Select any

Emergency Contact Information

Select any

(JPEG or PNG)

(JPEG or PNG)

Responsible party for payment:

How did You learn about Lifeway Counseling Centers? Check all that apply.