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.
This form gathers information that helps me understand who you are and what you are looking for in therapy.
PRACTITIONER DISCLOSURE STATEMENT
Important information about psychotherapy services and policies.
HIPAA NOTICE OF PRIVACY PRACTICE
Outlines Information about HIPAA laws and the protection of your personal information.
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.
You have the right to receive a Good Faith Estimate of what your services may cost.