New Client Paperwork

If you have an appointment, please print and complete the following new client paperwork.  This gives us more time to talk during your first session.

new client paperwork

Please complete the following addendum for child or teen clients.  If parents/guardians are divorced, we require a copy of the legal documents indicating the custody agreement and who has the legal right to consent to medical treatment.  In cases of joint custody, we require the signature of both parents at the time of the first session, unless your custody agreement specifies otherwise.

new client paperwork for children and teens

Please complete the release of information for your primary care doctor, psychiatrist, or other providers you want us to be able to communicate with.

release of information

What to bring to your first appointment:

  1. Completed New Client Paperwork
  2. Insurance card and photo ID
  3. Credit card – even if you plan to use another form of payment, we ask to keep a card on file as a back-up for any missed session fees, forgotten payments, etc.
  4. For minors – any necessary custody agreement documentation and signed consents for treatment

Please call your insurance company prior to your visit to ask about your coverage.  Most plans have a co-pay for therapy appointments and you may have additional responsibility if you have not met your deductible.  Our billing assistant is happy to help with any other questions about billing and insurance.

FAQ’s about counseling:

Counseling is an investment in your life, health, relationships, family, and future.

Initial assessment – $150
45-50 minute individual, couples, or family session – $130
Distance therapy 50 minute sessions – $130
Group therapy – varies

Some or all of these fees may be covered by your health insurance.

Reduced fee appointments available with Residents in Counseling. Please call for more information.

Cash, credit, HSA/FSA, or check.  A card is kept on file for each client but you may choose to pay with any method at the time of your appointment.
Natalie Wingfield, LPC and Phyllis Pierce, LCSW accept Anthem and Optima (non-Medicaid plans) and Tricare.

Tricare Prime does not cover our services without a referral. Please obtain a referral from your PCP and make sure it is approved by Tricare before your first appointment.

If you have another insurance we can still work together and can discuss the options with you.

Please call your insurance company prior to your visit to ask about your coverage.  Most plans have a co-pay for therapy appointments and you may have additional responsibility if you have not met your deductible.  Our billing assistant is happy to help with any other questions about billing and insurance.

We want therapy to be affordable for those who have financial hardship, are not seeking insurance reimbursement, and can not manage our full fee. We offer a few adjusted fee appointments with residents in counseling.
This depends on what is bringing you to therapy.  Generally clients start with once a week appointments and move to every other week later in treatment.  Some people start with twice a week.
Overall, we are conservative when it comes to medication.  What we mean is, we don’t jump to medication as the first line of treatment.  We help our client with coping tools and new skills to feel better.  In some cases, a combination of therapy and medication is the most helpful.  If we think medication could help with what you’re going through, we may help you find a doctor who will work together with our team.
Each person has unique needs and we customize our approach for you.  We use some of the more “traditional” talk-therapies such as Cognitive Behavioral Therapy.  We also incorporate art therapy, hypnosis, meditation, and other mind-body techniques.