New Client Paperwork
Welcome. Please download, review, and complete the forms below before your first session. If anything is unclear, bring your questions — we’ll go through them together.
Fees
I offer a sliding scale and a free initial consultation. I don’t ask what clients earn — I simply share this scale and ask that you pay what is appropriate.
| Annual income | Fee |
|---|---|
| $35,000 and below | $120 per session |
| $35,001 – $50,000 | $130 per session |
| $50,001 – $75,000 | $140 per session |
| $75,001 and over | $150 per session |
| Couples (60 minutes) | $160 flat rate |
Office Policies at a Glance
Sessions & Scheduling
Sessions are 50 minutes. 70-minute sessions are available for the session fee plus half. I recommend weekly sessions for the first month to build rapport, then we adjust together.
Cancellations
A 24-hour notice is required to cancel. Appointments canceled with less than 24 hours’ notice are charged $135, since the time was reserved for you. Insurance does not cover missed appointments.
Payment
Payment is due at the time of service. Couples’ sessions are a flat rate of $160.
Telehealth & Communication
Most virtual sessions are held on Doxy.me, which is HIPAA compliant. Email and text are convenient but not HIPAA compliant; texting is used only for scheduling or quick questions.
Confidentiality
Your sessions are protected by legal confidentiality, with limited legal exceptions such as mandated reporting and imminent safety concerns. Full details are in the disclosure statement.
Termination
If I have not heard from you in 30 days without prior arrangements, I will close your active file. We can always re-open it and begin a new episode of care.
This summary is for convenience only. The signed Office Policies & Disclosure Statement is the complete document.
In Case of an Emergency
If you are experiencing a crisis, call 911 or the 24-hour Mental Health Crisis Line at 425-258-4357 or 800-244-5767. You may also go to your nearest hospital emergency room.
Questions about the paperwork?
Reach out any time — I’m happy to walk through the forms with you.