2010 July Sun Mon Tue Wed Thu Fri Sat 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 August Sun Mon Tue Wed Thu Fri Sat 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Please print this receipt for your records. Please list telephone numbers where you can receive a blocked call in case the therapist is not in the office when contacting you to confirm your appointment. Include only email addresses and/or telephone numbers where you agree to accept a message if you're not available. Any information you enter on this form is strictly confidential. The first session is a 90 minute appointment to allow for administrative tasks, and sessions after that last 45-50 minutes. The therapist will contact you to confirm your appointment within 24 hours and answer any questions you may have. The initial session is $115 and subsequent sessions are $95 after that. We no longer do direct billing of any insurance companies but we can provide you with an insurance receipt to submit yourself for potential partial reimbursement if you have out of network coverage. Please let us know at your first session if you will want insurance receipts. Following your appointment request, you will be re-directed to the therapist's personal website which may be different from the website you scheduled from. There you will find answers to numerous questions under the FAQ's and also a wealth of information. Thanks for using e-scheduler and congratulations on seeking help. Available Appts: None at this time
