If you’re a new client, it is helpful if you print and fill out the Psychotherapy Intake Form. Also, please print, read and sign the Informed Consent and HIPAA form as this will save you time in our first meeting to focus directly on your concerns. The Informed Consent and HIPAA provide details about my practice, confidentiality and mandated reporting. I am happy to address any questions you may have about the information in these forms.
If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:
Our first counseling session is a comprehensive evaluation to include your history, significant life experiences and a clear picture of your current issues. This information will help us devise a plan to address your current therapeutic needs and devise a plan to support them. There is additional charge for this treatment planning. However, a typical session is 55 minutes at $135.00 per session.
Services may be covered in full or in part by your health insurance or employee assistance program. Please check your coverage carefully by asking the following questions:
- Do I have mental health insurance benefits?
- What is my deductible and has it been met?
- How many sessions per year does my health insurance cover?
- What is the coverage amount per therapy session?
- Is approval required from my primary care physician?
- How do my benefits vary for an out of network provider?
I am a preferred provider for Premera, First Choice Health, Moda and Lifewise. I am also happy to submit billing information to your insurance company as an out of network provider.
Payment is due at the time of the appointment. I accept insurance, cash, check and credit card. I try to be sensitive to the financial constraints of clients and have a portion of my practice available for sliding scale. Please inquire about this if you believe you may qualify.
If you do not show up for your scheduled therapy appointment, and you have not notified me at least 48 hours in advance, you will be required to pay the full cost of the session. Insurance companies do not pay for missed appointments.