Initial Appointment Screening

The initial appointment is very important, as I want to get to know you and your goals for counseling. We want to make sure that the therapeutic relationship is a good one for all involved. Please fill out this form so that I can understand the needs of you or your child. I want to make sure that I am a good fit for the counseling needs you or your child have.

initial appointment screening form

I will contact you once you fill out the form. We can then talk about next steps and see if we want to schedule the initial appointment.

Fees

My practice is out-of-pocket/private pay only.

Private Pay Fees:

Individual Initial Counseling Session (50-60 min) $140

Individual Counseling Session (50-60 min) $140

Cancellation Policy:

To avoid a $50 fee, notify us at least 24 hours prior to your appointment to cancel or reschedule.