Client Forms

If you are new, please complete these intake forms before the first session.

Client Intake Form and Consent For Treatment

Self-Pay Rates & Insurance

Self-Pay Rates

285

Initial Psychiatric Assessment

150

Medication Management Follow-up appointment

210

Medication Management Follow-up appointment w/cognitive and behavioral skills training.

Insurance

I accept Aetna, Cigna, Anthem Blue Cross Blue Shield, Oscar, Oxford, and United Healthcare.

K

Does my health insurance plan include mental health benefits?

K

Does my plan cover behavioral telehealth services?

K

Do I have a deductible? If so, what is it and have I met it yet?

K

Do I need a referral from my primary care physician to receive behavioral telehealth services?

Payment

I accept payment via Square, PayPal, CashApp, Zelle, and all major credit cards. I do not accept personal checks.

Cancelation Policy

If you cannot attend your appointment, cancel at least 24 BUSINESS hours beforehand to avoid missed and late cancellation fees. Remember that your health insurance provider will NOT pay for missed sessions.

Any Other Questions?

Please get in touch with me for any additional questions you may have. I look forward to hearing from you!

Payments

Appointment Request