Intake Form
Please fill out the intake form below and email or bring it with to your first appointment.
Session Costs:
Beyond 60 minutes, sessions will be prorated in 15 minute increments
Some Insurance companies are in-network and costs will be adjusted per contracted rate.
I am currently In Network with BCBS, Aetna, United Healthcare, Tricare and Optum. Please ask as other companies may be added.
Individual/Couples - 60 minutes
$175
Individual/Couples - 90 minutes
$262.50
Family - 2 hr
$350
Fees
No Show Fee
Charged for full appointment time
Not showing up for a scheduled appointment without at least 24 hour notice will result in being charged for the session.
Other Fees in Informed Consent Form
Court fees and other are listed within the intake forms