Individual/family sessions of 50-60 minutes are billed at $170.
I accept cash, check, Visa and Mastercard.
As every insurance plan is different, it is helpful to find out what your insurance plan's specific benefits and eligibility requirements are for mental health therapy. I am willing to bill your insurance company for you. I ask that you pay all co-pays upfront. A minimum cancellation notice of 24 hours is required or a full session fee will be charged.
Please fill out as completely as you can. Anything that is not filled out before the appointment will be completed at the beginning of the session. This is given to you in advance to try to minimize the amount of paperwork that will need to be done within the time constraints of our first session.
If you are coming in for couple or family counseling, just one of the adults can fill this out. If the primary client is a teenager, it is preferred that the teenager fill out this paperwork themselves. If you are filling this out for a child, please answer all questions as pertaining to the child.
The below forms will be sent prior to your initial session.
Intake Therapy Form
Additional Disclosure Form
Email Consent Form
If needed you can print out these below forms and bring to session.
If you would like me to coordinate care with another provider (for example your psychiatrist, primary care doctor etc.) complete the first form to authorize release of therapy information. General release of information-new client.doc
The second form pertains to consent for insurance billing if you will be using insurance. ROI-Insurance companies.doc
Specific Forms for Children and Adolescents:
Adolescent Informed Consent form.doc
Preferred provider for:
Anthem Blue Cross
First Choice Health
Premera Blue Cross
*Please contact me to discuss cash pay options if you do not have medical insurance or do not see your insurance listed. Please inquire to ensure I have availability.
If you are experiencing an emergency, please contact the Pierce County Crisis Line at 1-800-576-7764, or call 911.
If you are ready to begin you can call 253-326-2816
or email email@example.com
I am only able to respond to a small proportion of the phone calls that I receive (usually just current clients), because I do not have an office assistant. I am able to respond to emails quickly throughout the week. I review all of my phone messages, so rest assured that I have registered and appreciated what you had to say even if I was not able to respond by phone.