Fees & Forms
To make an appointment, please call (206) 799-8387 or email me at firstname.lastname@example.org.
My rate is $125 per 50-minute session and my RO-DBT class rate is $80 per class. I typically accept both personal checks and credit cards, but due to services being virtual I am only able to accept credit cards at this time.
I am paneled with Premera, Lifewise, and First Choice Health Network. For all other insurances, I am an out-of-network provider who can provide you with a receipt to be submitted for reimbursement from your insurance company.
Below you'll find the Client Intake Packet. This includes a Client Intake Form, a Policies and Treatment Agreement, Notice of Privacy Practices, and an Authorization for Release of Information form. If you have scheduled an appointment, please print and fill out the appropriate forms below and bring them to your first session.