Forms & Fees

Forms & Fees

“You have crystal
clear insights.”

Fees and Insurance

My fee for 55-60 minute sessions is $200, and for 80-90 minute sessions is $300. I schedule an 80-90 minute session for our first meeting, and for couples therapy, which is generally more effective with longer sessions. I require full payment by credit/debit/HSA card at the conclusion of each visit.

I have room in my practice for a few reduced-fee clients. If my fee is a hardship for you please discuss a reduced-fee option with me.

While I do not bill insurance companies directly, many will reimburse for my services as an out-of-network provider. I will provide a statement you may submit for reimbursement. You are responsible to contact your insurance company to verify whether your policy will cover my services, determine your benefit level, deductible, etc.

I suggest you ask the following questions:

♦ What are my mental health benefits?

♦ What is the coverage amount per therapy session?

♦ How many therapy sessions does my plan cover?

♦ How much does my insurance pay for an out-of-network provider?

♦ Is approval required from my primary care physician?

♦ Do I have coverage for couples therapy or only individual therapy?

New Client Forms

After scheduling an appointment with me please download/print/read/complete the following forms, and bring to your first visit:

1) Client Information Form

— One for each client

2) Communication Agreement

— One for each client

3) Disclosure Statement/Consent for Treatment

— All clients' signatures on one form

4) Notice of Privacy Practices

— All clients' signatures on one form

*** I am sorry, I am not taking new clients at this time. ***

1420 NW Gilman Blvd. #2313
Issaquah, WA 98027*

(425) 894-7686
© 2023 Brandi DeFazio