You're in great hands
If you're a new client, please complete the following forms and bring them to your first therapy session.
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:
$300.00 per 45 minute session for psychotherapy sessions; 400.00 per hour for Consultations and Mediations. All psychotherpay sessions are to be paid at the times services are rendered, although please note that we do have a 48 hour cancellation policy.
I am not on any insurance panels. However, many insurace companies will reimburse you for my service, when you provide them with a paid statement at the end of each month.Services may be covered in full or in part by your health insurance or employee benefit plan. Please check your coverage carefully by asking the following questions:
- Do I have mental health insurance benefits?
- What is my deductible and has it been met?
- How many sessions per year does my health insurance cover?
- What is the coverage amount per therapy session?
- Is approval required from my primary care physician?
- I am not a provider for any insurance carrier so will they cover a non- contracted provider
Reduced fee services are available on a limited basis.
Payments are accepted in the form of checks, cash and credit cards
If you do not show up for your scheduled therapy appointment, and you have not notified us at least 48 hours in advance, you will be required to pay the full cost of the session.
Request a therapy appointment online by contacting me at (310) 659-3824 or through email@example.com
Questions? Please contact me for further information.
The law protects the relationship between a client and a psychotherapist, and information cannot be disclosed without written permission.
Suspected child abuse or dependant adult or elder abuse, for which I am required by law to report this to the appropriate authorities immediately.
If a client is threatening serious bodily harm to another person/s, I must notify the police and inform the intended victim.
If a client intends to harm himself or herself, I will make every effort to enlist their cooperation in ensuring their safety. If they do not cooperate, I will take further measures without their permission that are provided to me by law in order to ensure their safety.