Patient Information

Intake Documents

• Cancellation Policy
• Consent for Telehealth Psychotherapy
• Credit Card Authorization Form
• Informed Consent
• Notice of Privacy Practices
• Practice Policies

***Intake forms must be completed prior to the session with your method of payment. If intake forms and payment information is not provided before the session, session will not be held and can be rescheduled.***

Session Fees & Insurance

Fully Licensed Clinician Session Fees
Intake/Couples/Families: $150
Individuals: $125

Intern Session Fees: Sliding Scale

Select Therapists Accept: United Healthcare, UHC Oxford, UHC Oscar, UHC Surest/UMR, Cigna

Insurances Pending In-Network: NYSHIP & World Trade Center Health Program

Out Of Network

If we do not accept your insurance we can provide super-bills to submit to your insurance for reimbursement through your out of network benefits.

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Open-Minded Marriage & Family Therapy, PLLC