Use this form to submit your counseling session payments. Once you hit submit, the page will redirect to PayPal to complete the transaction. Follow the prompts on the screen to pay with a PayPal Account, Credit, or Debit Card. Please enable JavaScript in your browser to complete this form.Are you meeting with your counselor remotely? *YesNoName *FirstLastEmailPhone *Address *Address Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEnter your amount due - Assigned by your counselor *If you do not know your amount due, contact your counselor.Comment or MessageEmailSubmit