Sliding-Scale Counseling Request Form
Haga clic aquí para Español. / Click here for the form in Spanish.
This form is for individuals, couples, families, and other intimate relationships looking to be matched with one of our trainees for sliding scale counseling. Our sliding scale fees are based on all financial resources, not just personal income. The lowest fee possible on our scale is around $25 per session, and the highest fee on our scale is around $130 per session. We encourage joining with our monthly membership, which reduces the overall cost of sessions.
PLEASE NOTE:
As of September 2025, our waitlist is approximately 1 month.
Our waitlist tends to move more quickly in the fall and slow down in the spring. We encourage you to check out our groups in the meantime, some of which you can join immediately.
If you have any questions, please call us: (323) 935-1807
Taking the first step towards building more support in your life takes courage. We’re honored to be one of the resources you are reaching for.
As you fill out this form, the more information you are comfortable providing, the better. The information you submit here will not be shared with anyone outside of The Relational Center.
If you are more comfortable speaking with someone over the phone to submit your request, we welcome your call.
If you have already submitted a request, you are welcome to contact us for an update on your waiting list status.
Counseling Request Form