Forms & Rates
Forms to start Therapy
The three forms below need to be completed before your first session. This helps therapy begin with a clear understanding of the boundaries, expectations, and protections in the relationship.
*Each form below has two options to complete. Must have a google account to complete using Google Forms (easiest option). Alternatively, there are links to PDF forms that can either be completed electronically or print/scan and then emailed.*
Client Intake Form (Google Form) OR Client Intake Form (link to PDF)
Informed Consent (Google FORM) OR Informed Consent (link to PDF)
Contact Information and Credit Card Authorization (Google FORM) OR Contact Information and Credit Card Authorization (link to PDF)
Sometimes you may want information shared to/with another provider. This could be for many reasons but since you determine access to your private health information a signed Release of Information (ROI) is needed before anything can be shared.
Rates for Therapy
Therapy is an investment in yourself. Every dollar spent goes directly towards a valuable service individually tailored to your specific needs and issues. Your time and energy are valuable so therapeutic work will be focused and engaging.
Therapy Clients with Growth and Gratitude, PLLC have improved their relationships and reduced anxious thoughts and feelings. This can be measured in improved relationships, higher self-esteem, and lessened anxiety and depression.
Standard session fees:
FREE | 20 minute Phone Consultation
$175 | 50 minute Telehealth Video session
$250 | 90 minute Telehealth Intensive
$55 | 20 minute Phone Consultation (as needed)
Growth & Gratitude, PLLC Does NOT Take Insurance
We partner with clients who are seeking the highest degree of privacy and choice in their providers and for that reason no longer accept insurance as a form of payment.
For clients that want to use their insurance benefit for therapy please login to your insurance company website to search for a provider that accepts your plan.
Payment
Credit or Debit payments for PRIVATE PAY are made thru Square. This tool is designed to meet your privacy and security needs. Payment authorization is required prior to a scheduled session so that the time is reserved specifically for you and we can use our time to focus on your individual therapeutic needs. A credit card will be held on-file to facilitate this and will be charged the same day of the session.
Cancellation Policy
If you are unable to attend a session, please make sure you cancel at least 24 hours beforehand. Otherwise, you will be charged for the full rate of the session.
Any Other Questions
Please contact me for any additional questions you may have. I look forward to hearing from you!