FORMS & FEES
FORMS
Please complete the below paperwork prior to our initial meeting so that we can spend our time together focusing on what brings you to therapy.
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This form gathers information that helps me understand who you are and what you are looking for in therapy.
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PRACTITIONER DISCLOSURE STATEMENT
Important information about psychotherapy services and policies.
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HIPAA NOTICE OF PRIVACY PRACTICE
Outlines Information about HIPAA laws and the protection of your personal information.
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FEES
50 minute Individual Counseling Session: $175
50 minute Couples Counseling Session: $200
On principle of upholding your privacy, I am not currently listed with any insurance providers. Some clients may be able to seek full or partial reimbursement by submitting an invoice to their insurance company. I would encourage you to contact your insurance company and inquire what their reimbursement rate is for an out of network provider. In order to accommodate those with financial need, I offer a limited number of reduced rate appointments. If you would like more information about this, please do not hesitate to ask.
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You have the right to receive a Good Faith Estimate of what your services may cost.