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You are entitled to receive this “Good Faith Estimate” of the estimated charges for psychotherapy services provided to
you. While it is not possible for a psychotherapist to know, in advance, how many psychotherapy sessions may be
necessary or appropriate for a given person, this form provides an estimate of the cost of services provided. Your total
cost of services will depend upon the number of psychotherapy sessions you attend and your individual circumstances.
This estimate is not a contract and does not obligate you to obtain any services from the providers listed, nor does it
include any services rendered to you that are not identified here.
This Good Faith Estimate is not intended to serve as a recommendation for treatment or a prediction that you may need to
attend a specified number of psychotherapy visits. The number of visits that are appropriate in your case and the
estimated cost for those services is unknown and based on your needs, preferences, progress made in therapy and what
you agree to in consultation with your therapist. You are entitled to disagree with any recommendations made to you
concerning your treatment and you may discontinue treatment at any time.
The fee for a 50 minute individual therapy session (in-person or via telehealth) is $150.00. Most clients will attend weekly
or bi-weekly therapy sessions, though some may attend more or fewer sessions per month, depending on individual
needs. Your ultimate total fee for treatment services will be the number of sessions multiplied by the ongoing session fee
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