New Client Forms

Please download and fill out the following forms and bring them with you to your first visit.

   INTAKE FORM

   INFORMED CONSENT & RESPONSIBILITIES

   RELEASE FORM

   CREDIT CARD AUTHORIZATION FORM

 

Payment Information

$230 for a one-hour session

Payment is due at the time of session.
The following forms of payment are accepted:
Cash, Check, Venmo: @Jessica-Getson

A 24-hour notice to cancel a session is required or the client will be responsible to pay for the session.

Insurance Reimbursement

As an “out of network” licensed clinician, clients pay me at the time of each session but are potentially eligible for reimbursement from their insurance carrier. I provide clients with receipts that can be submitted to insurance for out-of-network reimbursement.

To find out your eligibility to receive reimbursement from your insurance company, call them and let them know you are seeking mental health counseling from a Licensed Professional Counselor (LPC) and ask the following questions: 

1) “Do I have out of network benefits?”

2) “What is my deductible?”

3) “Once my deductible is met, what percentage or dollar amount of the fee is reimbursed back to me?”