NEW CLIENT FORMS

New Client Information, Consent & Policies – PLEASE READ & COMPLETE BEFORE 1st SESSION

Release of Information

Tele-Health Psychotherapy Consent Form

Client Information for filing a complaint with the Board of Behavioral Science Examiners


Rates & Insurance:  
My current fee is $150 per session. I have a limited number of sliding scale and insurance slots available. When my insurance slots are full, I can provide you a Statement which you can submit to your insurance company for reimbursement. For further information, please see above – “New Client Information, Consent & Policies.” 

I accept the following payment forms:  cash, check, credit card (with a 3% processing fee), and Venmo.