If you are a new client, please complete the following forms and bring them to your first therapy session. Couples and families, please complete the Marriage and Family Patient Information form.
All clients must complete the Professional Services Agreement.
If you would like to allow coordination of care with another provider (for example, a psychiatrist, primary care physician, etc.), complete this form to authorize release of information:
Other forms that may be required are:
Individual Counseling is $100 per 60-minute session. Individual client is responsible to pay $25 per ¼ hour of psychotherapy services unless otherwise negotiated.
Couples and Family Counseling is $120 per 60-minute session. Couples and family client is responsible to pay $30 per ¼ hour of psychotherapy services unless otherwise negotiated.
Family Sessions are usually 60-90 minutes. Initial sessions are 90 minutes.
Insurance is Not Accepted at This Time
Full payment shall be made by the patient at the end of each session. Patients agree to pay for professional services even if such services are covered by insurance. You may want to speak to your insurance carrier about reimbursement options for out of network providers, as they frequently provides clients with receipts for reimbursement.
Special arrangements can be made to accommodate your budget. My goal is to help you while maintaining my professional ethics.
- All major credit cards
If you need to cancel an appointment, please try to do so at least 24 hours before your scheduled appointment. If you miss a session, and have not cancelled, you will still be charged for the full price of the session.