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Client Paperwork
Please print paperwork and bring to your intake session.
Professional Disclosure
HIPPA
Credit Card Authorization
Release of Information
Parent information
Paperwork: FAQ
Service Fees:
Intake Session: $165.
Individual Counseling: $150.
Play Therapy: $150.
Couples Counseling: $150.
Family Counseling: $150.
Insurance:
I take Blue Cross Blue Shield of WY insurance and will bill for you.
For other insurance I will provide a
Super-Bill for services rendered at the end of each session. Payment is due in full at the time of service.
(exception- BCBSWY)
Types of Payment: Cash, Check, Visa, MasterCard, American Express.
Sliding Scale- Yes
Paperwork: Welcome
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