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Intake Form

For your convenience, download, print and complete this form prior to our first meeting.


Individuals-$120, Couples-$130 and families: $130

Inquiring University Students: $75 (sliding scale if needed)



The decision to not work directly with insurance company for the following reasons:

  • Insurance companies require an assignment of mental health diagnosis in order tocover the cost of therapy. A majority of people seek counseling and are interested in learning new skills and strategies to improve their lives and relationships, and do not necessarily have a mental health diagnosis. It is preferred not to provide one when there is believed to be none that exists.

  • Restrictions are often placed on the type of services covered by many insurance companies. For example, marriage and family counseling are not often covered by insurance companies.

  • Insurance companies place restrictions on the course and durations of treatment. This effects the ability to prescribe the treatment plan that may be considered the most beneficial for you.


If you would like to submit for insurance reimbursement, a receipt with a diagnostic and CPT code can be provided for you. It has been found that some insurance companies will reimburse anywhere from 50%-80% of out of network services. Checking your coverage for out of network mental health services is encouraged.


The following questions may be helpful when inquiring with your insurance provider:

  • Do I have mental health insurance benefits?

  • What is my deductible and has it been met?

  • Do I need a referral from my primary care physician for counseling?

  • How many sessions are covered by my health insurance?

  • What is the amount covered per therapy session?


Reduced Fee services are available on a limited basis.

Payment accepted at this time is check and cash.

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