Intake Form

My practice is private pay; services provided are as an out-of-network provider. Your insurance coverage is dependent on your current health insurance provider or employee benefit plan. I provide clients with a receipt (superbill) for reimbursement that you can submit to your insurance provider for reimbursement at the level they pay.

Not showing up for a scheduled appointment without at least 24 hours notice will result in being charged the full session fee. [Appointments longer than 1 hour will be charged 50% of the total charge for the total time scheduled.]