Policies + Forms

Insurance

I am an out-of-network provider for clients located in NY and CT.  Payment is due at the time of the service.  While I do not participate on any insurance panels, I am happy to provide you any documentation (including a clinical receipt of services), which you can use to submit to your insurance or health savings plan. Some insurance plans may cover part of the cost of out-of-network providers; you would need to call your insurance company to inquire about your plan. Please note that insurance companies generally require a mental health/illness diagnosis to pay for sessions, and if a diagnosis is given, that will be recorded into your permanent file.  

Payment

Payment of fees for services is required at the end of each session.  I currently accept personal checks or Venmo payments. 

Cancellation Policy

I understand things come up, so you can cancel or reschedule your appointment with at least 24 hours notice. If your appointment is scheduled for a Monday, you must cancel the appointment during office hours the Friday prior. Appointments that are cancelled late or missed will be your financial responsibility, as no insurance company will pay for these charges. The charge for a missed appointment is $100. This is because sessions are scheduled on a first-come, first-served basis. Your appointment time is reserved specifically for you.   

Intake Forms

You may go ahead and print and fill out the intake paperwork (see the links for Client Intake Form and Informed Consent below) and send it back to me via email.  I ask that you bring questions about the paperwork, me or the process of therapy with you to the first session.

The following are forms for you to read; you are welcome to print a copy for yourself.

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, or an individual or couples therapist, etc.), complete this form to authorize release of psychotherapy information: