Good Faith Estimate

You are entitled to receive a “Good Faith Estimate” of what the charges could be for the mental health services provided to you. While it is not possible for me to know, in advance, how many  sessions may be necessary or appropriate for a given person, this form provides an estimate of the cost of services provided. Your total cost of services will depend upon the number of sessions you attend, your individual circumstances, and the type and amount of services that are provided to you.  The cost for my services can be found HERE. 

There may be additional items or services I may recommend as part of your care that must be scheduled or requested separately and are not reflected in this Good Faith Estimate. This estimate is not a contract and does not obligate you to obtain any services from me nor does it include any services rendered to you that are not identified. If you receive a bill that is at least $400 more than your estimate, you can dispute the bill. 

Make sure to save a copy or picture of your Good Faith Estimate.