Rates, Insurance & Forms

Rates, Insurance & Forms2018-04-20T14:21:57+00:00

Rates, Insurance & Forms

I hold a few sliding scale slots based on ability to pay and availability.  With private pay insurance, a statement would be produced monthly for you to obtain reimbursement.

Forms

Once you schedule an appointment with me, please download the forms below and bring them to our first session.  Filling the forms out ahead of time will allow us to optimize our therapeutic time together.

Rate

$1800050 Minutes
  • Therapy Session
Client Information Form
Initial Interview Form
HIPAA Notice
HIPAA Acknowledgement

If I will be treating a minor (under the age of 18), please fill out these forms instead.

Initial Interview Form
Child Treatment Agreement
Client Information Form
HIPAA Notice
HIPAA Acknowledgement