$165 per 50 minute session
Cash, check and major credit cards accepted for payment.
Your appointment time is set aside just for you. If you are unable to attend, please notify me at least 24 hours in advance. If not, you will be required to pay a forty-five dollar no show fee.
Cash, check, or credit card, at the close of each session.
Please print the Client Consent Form, HIPAA Form, and Client Information Form. Complete the Consent and Information Forms and bring them to your first session. The HIPAA Form is for your personal records, as it pertains to how your medical records are protected by law.
Adult – Informed Consent Form
Minor – Informed Consent Form
Adult Psychotherapy Intake Form
Child Intake Form
Limits of Confidentiality/Therapy Cancellation Policy
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:
Authorization to Disclose Information Form
Limits of Confidentiality
State and federal law protect confidentiality between client and therapist. Traditionally, the content of counseling sessions cannot be disclosed without consent of client. There are several exceptions:
Suspected child abuse or dependent adult or elder abuse. Therapist is required by law to contact authorities within a twenty-four hour period.
If a client threatens serious bodily harm to another persons(s). Therapist must contact authorities immediately and inform identifiable victim(s), when possible.
If client intends to harm self. If client is not complying with self-care coping skills, therapist will contact authorities immediately to ensure client’s safety.