Policies and useful forms
There are several important practical matters that go along with starting therapy. Please let me know if you have questions or concerns—I will be happy to talk about any of these policies with you.
Email: Is the best way to reach me! email@example.com
If you are having an emergency of any kind and need to talk to someone immediately, please leave a message for me, then go to or call the nearest emergency room and ask to speak to a member of the psychiatric emergency team.
Fees and Billing: My current fee is $210.00 for each individual 50-minute session. I charge for full payment via credit card after each session. Longer appointments can be requested and are charged on a pro-rated basis.
Insurance: I am an “out-of-network provider” for insurance plans, which means that you may receive anywhere from zero to partial reimbursement for our sessions, depending on your plan. I give many of my clients a specialised "Superbill" receipt that can be submitted to an insurance company.
Cancellations: Missed or cancelled sessions present a special problem in psychotherapy for two reasons.
The first is that the work itself is sometimes difficult, and thus when we hit a rough time you might be tempted to avoid coming in—it is my job to support you to face these things, and therefore important that I do not enable you to miss needed sessions.
The second reason is that the appointment time is set aside specifically for you and typically cannot be given to someone else on short notice. Cancellations should be arranged as far in advance as possible. If you cancel or miss an appointment with less than 48 hours notice, I will charge you for that visit. For visits cancelled with more notice, we will reschedule for a mutually convenient time—but if we cannot find a mutually agreeable time within the same week, I will charge for the missed visit.
Consultation: It is customary and prudent for psychotherapists to consult with respected colleagues about their work. When I consult with colleagues, I will not identify you by name and will be careful to respect your confidentiality.
Confidentiality: This is always of primary concern in psychotherapy and is strictly observed. Exceptions are made only in those cases specified by law, such as if, in the course of our work, it appears that you are at imminent risk to harm yourself or someone else. The law also mandates that confidentiality be set aside in cases of abuse of children, the elderly, and the handicapped. Similarly, the law mandates reporting of instances of misconduct or abuse on the part of a physician.
The question of confidentiality becomes more complicated when insurance is used for payment or reimbursement of fees. Insurance companies often request information about treatment and the reason for it, and occasionally ask for treatment summaries to determine whether — in their opinion — further coverage is justified. I cannot guarantee the treatment of information routinely submitted to an insurance company.
Forms: The forms below can be downloaded, filled out and brought to our first session together. They cover confidentiality, exceptions to privacy, and several other important matters regarding our work together.
Please feel free to discuss these or any other matters with me during our time together.