Insurance
We encourage you to learn about your mental health benefits by contacting your insurance company and inquiring about your mental health benefits. Our practice is in-network for Blue Cross/Blue Shield PPO insurance plans. For other insurances, you may receive direct reimbursement through your out-of-network benefits. As a courtesy to our clients, we submit out-of-network claims on your behalf. Please note that you are ultimately responsible for any charges for services rendered so it is important to inquire about your deductible, co-insurance, and/or copay before the commencement of treatment.
Payment
Payment is accepted in the form of cash, check, or major credit cards at the time services are rendered. If you wish to pay via credit card, please utilize the following forms:
Credit Card Billing Form (Nicholas)
Credit Card Billing Form (Noble)
Cancellation Policy
Any cancellations of appointments must be made at least 24-hours in advance of the scheduled session. If you do not call to cancel and/or fail to show, you will be charged the full fee for that appointment. If you need to reschedule an appointment, please contact us as early as possible and we will make every effort to schedule another time to meet.
Forms
Once you schedule your first appointment, you may print and complete the following forms and bring to our initial session. If you are not able to do so, please arrive 10 minutes early to complete the necessary paperwork before your appointment time.
New Clients:
HIPAA Notice (for review, no printing/signature needed)
Adolescent & Marital/Couples Counseling: (complete along with New Client Forms)
Informed Consent for Adolescent Therapy
Informed Consent for Marital/Couples Therapy
For Release of Confidential Information to designated party: