Information and Forms:
If you would like to get started on paperwork prior to your first appointment:
Please print and fill out the first 2 forms below and bring them to your appointment.
| Client Information Form |
| Informed Consent |
If you would like me to coordinate care with any other provider (such as school counselor, prior therapist, psychiatrist) about any aspect of your psychotherapy please fill out the form below. One per provider.
| Release of Information |
Rates:
$210 - $225 per 50-minute session
90 minute sessions available and billed accordingly
90 minute sessions available and billed accordingly
Reduced fee services are available on a limited basis.
Insurance:
I am an out of network provider on all insurance plans. I will provide you with a statement of psychotherapy services that you may submit to your insurance company for reimbursement. Services may be covered in part by your health insurance or employee benefit plan. When you check your coverage the following questions may be helpful:
- Do I have mental health insurance benefits?
- What is my deductible and has it been met?
- How many sessions per year does my health insurance cover?
- What is the coverage amount per therapy session for an out of network provider?
- Is approval required from my primary care physician?
Payments:
I accept credit cards, checks and of course, cash. Payment is due on the date of service.
To make a payment via PayPal click below:
To make a payment via PayPal click below: