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Teletherapy Consent Form

HIPAA

Current Medications

Client Information

Service Agreement

Hours

My office is open for appointments Monday through  Thursday. You may call and leave a message at any time and I will return your call within 24 hours. .  

Cancellations and Closures

All appointments must be cancelled or rescheduled at least 24 hours prior to the scheduled appointment to avoid a late cancellation fee. The charge for late cancellations and no-shows is the full session fee. If I can reschedule you another time during that same week, the Late Cancellation/No-show fee will be waived.  The office is closed on following holidays:

Memorial Day, Independence Day, Labor day, Thanksgiving day, December 25 and New Year's Day.

Payment

Fees: $185 per session for Individual, $210 for Couples. Fees are subject to change. Full fee is expected at the time of the session. Please check on the reimbursement policy of your health insurance policy.  Invoices for session payments are emailed at the end of each month but this can be changed according to your individual needs.