Disclosure – Confidentiality Form
Sessions and Cancellations
Sessions are 60 minutes long, unless otherwise agreed. Cancellations require 24 hour notice, or payment for the full session is due at the next appointment.
Payment in full is due at the time of each session, by cash or check.
Fees for parent/child or families are $120 per session.
Fees for couples, $120 per session.
Fees for individuals is $90 per session.
Telephone consultation will be charged at $25 per 15 minutes. Payment is due at the beginning of your next scheduled session.
Routine calls and scheduling calls of less than 10 minutes are no charge.
Out of office work, such as consultation with school or physician will be scheduled with advance parental agreement and billed at $100 per hour, including travel time. These services will be billed to you at the next session and payment will be required at that time.
I am in the process of enrolling with insurance companies as a network provider at this time. While in this process, all sessions are private pay. I can provide paperwork (1 page) for you to submit to your insurance company for reimbursement on your plan.