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    • Home
    • About Me
    • My Therapeutic Approach
    • Forms / Fees
    • Contact Me
  • Home
  • About Me
  • My Therapeutic Approach
  • Forms / Fees
  • Contact Me

Intake Form

Please click the appropriate link below, fill out the intake form and bring with to your first appointment.

CKCS PLLC Adult Intake form (pdf)Download
CKCS minor intake form PLLC (pdf)Download

Fees

Session Costs

Beyond 60 minutes, sessions will be prorated in 15 minute increments

Individuals - 50 minutes

$130

Couples / Family - 50 minutes

$150

Couples / Family - 80 minutes

$225

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Couple / Family - 2 hr (110 mins)

$300

Insurance

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.

No Show/Late Cancellation Fee

Full session cost

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.] 

I consider financial circumstances / have a sliding scale in some situation

Based on need

Chris Kingsbury Counseling Services

925 Main Street, Suite B, Liberty Hill, TX 78642

(512) 948-9253

Copyright © 2021 Chris Kingsbury Counseling Services - All Rights Reserved.