Session Fee Schedule

My fee is $95 per session for ongoing individual sessions, $120 for couples and $135 for all initial sessions only.  Brief, shorter sessions are $60; extended sessions are $150. Full payment is made at the time of session by personal check or cash.  If you would prefer to pay via credit card or direct bank draft, you may pay online using paypal. (This will increase the cost due to the 3% fee paypal charges.) For clients with health insurance coverage, I have a business manager available to help estimate your coverage, file insurance claims, and advocate on your behalf with your insurance company.  If you prefer to file your own insurance, I will provide you with the information you will need to file claims.  We are currently able to file electronically with several insurance companies which speeds up your reimbursement process.  In addition, I am currently qualified as a Medicare provider and am a participating Project Access provider.  For clients without current health insurance coverage and experiencing financial hardship, the fee may be negotiable.  Please ask about this when scheduling our initial session. To pay using Paypal, click here: Fee schedule

Forms

There is a minimal amount of paperwork Gayle will need you to complete. Depending on what works best for you, you may plan to complete these forms in the office waiting room following our first session. Please allow an extra 10-15 minutes to do so. Alternatively, you may prefer to print them yourself prior to our first appointment, review them at your leisure and bring them to the first session completed. All clients will need to complete one of the Client Information and Contract forms below - choose either the individual or couples version depending on which type of therapy you are pursuing.  Please also read over the HIPAA Notice and bring with you a completed Receipt of Notice. Client Information and Contract - (For clients to be seen individually) Couples Information and Contract - (For clients to be seen as a couple) Notice of Privacy Policies (For clients to review, HIPAA compliance) Acknowledgment and Receipt of Notice (All clients must sign after reviewing notice) If you would like my business manager to file insurance for you, then we will need the top half of the Health Insurance Claim Form completed and signed also: Health Insurance Claim Form - [Called a CMS-1500/HFCA 1500] (print page 1 only and fill in name, address, date of birth and insurance info only - boxes 1-13) Finally, two consent forms are available should the need arise: Consent to Share Information (For clients to sign in situations of collaboration with other medical professionals) Consent for EMDR Therapy (Needed for EMDR clients only.)

Community Links

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