Adult, Child and Family Counseling

Willie Holcomb, LCSW
Fee Schedule and Forms

Sliding-Scale Fee Schedule



Combined Gross Family Income                    Therapy Fee Per Session*    
$10,000 & Under                                                             $30
$10,001 - 15,000                                                              $35
$15,001 - 20,000                                                              $40
$20,001 - 30,000                                                              $45
$30,001 - 40,000                                                              $50
$40,001 - 50,000                                                              $55
$50,001 - 60,000                                                              $60
$60,001 - 70,000                                                              $65
$70,001 - 80,000                                                              $70
$80,001 & Above                                                              $75

*ACF Counseling accepts payment by check or cash only.



IMPORTANT  INFORMATION  --  INTAKE  FORM

To avoid taking time during your appointment filling out paperwork, please print the Intake Form and fill it out and bring it with you on the day of the appointment.

Click HERE for the Intake Form. The form will open in a new window. Please print the form, review and complete the information requested. Please remember to sign the form. Couples who are coming to an appointment together may use the same form. Each person will also complete a Burns Depression Checklist in the office.


Adult, Child and Family Counseling
Willie Holcomb, LCSW

2964 Ole Bartlett Court
Suite #6
Bartlett, Tennessee  38134
(901) 237-4969 cell
(901) 881-6171 phone/fax