New Client Forms

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

   INFORMED CONSENT & RESPONSIBILITY

   CLIENT INTAKE FORM

   CREDIT CARD AUTHORIZATION FORM

   RELEASE FORM

 

Counseling Rates and Payment Information

  • The initial session is one hour in length and the cost is $300.
  • All sessions thereafter are one hour in length and the cost is $250 per session.

Payment is due at the time of session.

The following forms of payment are accepted:
Cash, Venmo: @Jessica-Getson and checks are the preferred method of payment. Credit Cards are also able to be charged if needed.

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?”