EMBARK ON A JOURNEY WITH ME

I make sure all my new clients feel welcome, safe, and taken care of.

750 Officers Row Vancouver, WA 98661

(Please only fill out paperwork if you’ve had a conversation with me previously)

Practice Services and Fees Schedule

Session Length and Frequency:

Individual therapy sessions are 50-minutes in length
Sessions can be shorter or longer when necessary and agreed upon by the therapist and client(s).
Typically, sessions are weekly or can be scheduled more or less frequently, as agreed upon by the therapist and client(s).

Session Fees:

Financial Policies

Insurance: I take several insurances, including Kaiser AND Pacific Source. If you have out-of-network mental health insurance benefits, you will pay my fee, and I will provide you with a bill to submit to your insurance for reimbursement.
Health Savings Accounts: Another way to cover the cost of therapy is to use your Health Savings Account or Healthcare Flexible Spending Account card to pay for treatment. To do this, submit your HSA or HFSA card in the form asking for a credit card number.

How to pay for services:

I can accept debit cards, credit cards, checks, cash, and health savings account cards as payment.
As part of this packet, I will request your credit card information to keep on file and to bill your fees for sessions.
Therapy cannot continue unless your balance from previous sessions and associated fees are fully paid.

Missed Appointments and Late Cancellations

Failing to show up for your appointment denies that time to someone else, resulting in lost income to me.
Appointments may be canceled without charge up to 48 hours before the appointment time. This allows me to offer the spot to someone else. If you cancel after the 48-hour deadline or do not attend your appointment, you will be billed a $165 fee for the missed session. Insurance does not reimburse missed session fees.
To cancel or reschedule an appointment at any time, call or text me at 415-309-3578.

Additional Information

In compliance with the No Surprises Federal Healthcare Act that took effect on January 1, 2022, all healthcare providers must notify clients of their federal rights and protections against "surprise billing." This Act requires that I inform you of your federally protected rights to receive a notification when services are rendered by an out-of-network provider, if a client is uninsured, or if they elect not to use their insurance.
You need to be aware that by choosing to forgo using your insurance for services or an out-of-network provider, you are choosing to pay more for services than you would if you were using your insurance benefits.

Additionally, I am required to provide you with a Good Faith Estimate of the cost of services. It is difficult to determine the true length of treatment for mental health care, and each client has the right to decide how long they would like to participate in mental health care. Therefore, attached you will find the Practice Services and Fees Schedule for the services typically offered by me as your therapist. You and I will collaborate on a regular basis to determine how many sessions you may need to reach your treatment goals. It is a federal requirement that I have each client sign this document to begin/resume treatment. If you have any questions, please don't hesitate to ask.

If you have any questions, send me an email