Estimated Cost Per Visit
- Evaluation: $225
- 30-minute treatment: $120
- 60-minute treatment: $200
30-minute packages (must be completed within a month):
- 4 Visits: $450
- 8 Visits: $875
- Unlimited monthly visits: $1600
60-minute packages (must be completed within a month):
- 4 Visits: $750
- 8 Visits: $1450
- Unlimited monthly visits: $2500
Each package is non- refundable, and visits do not roll forward to the next month. The first package purchased does include the initial evaluation visit. Cancelled visits will be rescheduled based on therapist availability within the monthly time limit. After the month ends, the package will expire.
By signing below, I attest that I meet the requirements to participate in the Patient Self Pay program. The contents of this form have been explained to me, and I have voluntarily signed this agreement before receiving the described services. I have been told hat the estimated costs will be. I agree to pay for the services in full or within the guidelines of a formally established payment plan between myself and the Provider.