I offer both online therapy and in-person therapy sessions. I am an out-of-network provider, please see information regarding insurance below. To help us discern if we’re a good fit, I provide a complimentary 20-30 minute Zoom consultation. For couples or relationship work, it is necessary for both individuals to be present on the same camera. To schedule an initial consultation please contact me.
Forms for Online Therapy and In-Person
Once we decided that we will work together, whether we meet in person or virtually, please attend to the following forms and return the signed and filled out forms to your first session, or email them back to me if we meet online.
Digital Certificate Signatures
If you have a saved digital certificate signature, you may apply it to the forms below that require a signature. If you do not have a digital certificate signature, you have two options: 1. download and print the forms, and manually sign them. 2. Create your first digital certificate signature which is explained in this tutorial.
Forms will both download to your computer and show in your browser
(results may vary depending on your browser)
Information Regarding Insurance
Insurance for individual therapy: At this time I do not accept insurance for online therapy or in-person therapy. However, some insurance plans will cover my work as an out-of-network provider. I will provide you with the respective codes, nevertheless it is your responsibility to submit the paperwork so that you might be reimbursed. Please contact your insurance company for more information.
You must be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk to confidentiality, privacy or to future capacity to obtain health or life insurance or even a job. The risk stems from the fact that mental health information is likely to be entered into big insurance companies’ computers and is likely to be reported to the National Medical Data Bank. Accessibility to companies’ computers or to the National Medical Data Bank database is always in question as computers are inherently vulnerable to break in’s and unauthorized access. Medical data has been also reported to be legally accessed by enforcement and other agencies, which also puts you in a vulnerable position.
Insurance will not cover missed sessions for those getting reimbursed by their health insurance company.
Insurance for couple/relationship(s) therapy: Your relationship (rather than an individual) is the focus and identified client in these forms of counseling. Most insurance plans do not deem these services medically necessary and decline to cover them. For this reason, reimbursement for our sessions from your insurance may not be possible and, when covered, your relationship counseling sessions may be limited to 50 minutes. If you have questions about your coverage, I recommend contacting your insurer and asking, “Under my plan, is CPT code 90847 with ICD-10 diagnosis code Z63.0 a covered benefit?” I’d be happy to talk with you about questions you may have; however, you remain responsible for paying for any services you choose to receive.