Forms and Insurance
Insurance
I am an out-of-network provider. Many clients still choose a private pay/out-of-network therapist for the privacy and flexibility it offers. I can provide a monthly invoice (superbill) that you submit to your insurance company for reimbursement; because every plan is different, reimbursement varies widely. It may be helpful to check with your insurance carrier to understand how your specific plan reimburses for out-of-network psychotherapy services.
Payment
I accept cash, check or Venmo.
Cancellation Policy
To avoid being charged the full rate, please cancel your appointment at least 24 hours before your scheduled session.
Any Other Questions
Please contact me for any additional questions you may have. I look forward to hearing from you.
Client Forms
- Informed Consent is the process by which a person understands the risks and benefits of treatment before agreeing to participate.
- Intake Form collects basic personal, contact and background information.
- Good Faith Notice explains your right to receive an estimate of expected charges.
- Good Faith Estimate provides a written estimate of expected charges for treatment.
- Release of Information authorizes the sharing of confidential information with another healthcare provider or third party. (With few exceptions, your information is confidential; at times, it may be helpful to have your treatment team talk together. When this exchange is needed, you must authorize that release of information.)