Forms & Pricing
Resources
Please download and complete your required intake packet, and don’t forget to bring it to your first appointment!
Please download and complete the required Release of Information forms if requested by your therapist.
Sessions
Reading /responding to emails
and phone calls | $25 per 15 minutes
Fees
First time No Show, Late, or Cancelation | $50
Future No Show, Late, or Cancelation | $75
Failure to pay within 10 days of denied insurance claim | $25
Court appearances, preparation, and
third party conferences | $225 per hour
School expulsion assessment | $225
Please Keep in Mind
The fees mentioned above may be different if you chose to utilize insurance benefits.
**HSA cards accepted
It is also your responsibility to call your insurance company to determine benefits, deductibles, copays and any limits to number of visits for mental / behavioral health.
Notice: Good Faith Estimate
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees. Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.
Thank you.
For more info, visit: www.cms.gov/nosurprises