If you have any questions and would like to set up a free 15 minute consultation, please don't hesitate to contact me!
call (206) 858-0247 | email firstname.lastname@example.org
Offices in Seattle and Bellevue:
University Business Center
4500 9th Ave NE Suite 300 #24 | Seattle, WA 98105
Wilburton Ridge Office Park
345 118th Ave SE, Suite 100 | Bellevue, WA 98005
I charge $120 for 50 minute sessions and $195 for 90 minute sessions. I accept Premera Blue Cross, LifeWise Health Plan of Washington and LifeWise Assurance Company, and I will bill these insurance companies directly. If you have a different insurance, I can also provide you with a superbill that you may submit to your insurance company.
*Please note that I am not currently accepting clients requiring a sliding scale.
Please notify me as soon as you know you must miss an appointment. You must cancel 24 hours prior to your appointment or you will be charged in full for the session. Please note that insurance does not reimburse for late cancellations.
Authorization for Release of Information Forms
The Health Insurance Portability and Accountability Act (HIPAA) of 1996 dictates that your health care providers must obtain a signed release form in order to discuss your personal health information. Please have any relevant medical records forwarded to my office. Links to various providers and organizations' release forms are provided below.
- Polyclinic Group Health
- Seattle Children's Hospital
- Medical Center Swedish Medical Center (all campuses)
- University of Washington Medical Center & Clinics
- University of Washington Neighborhood Clinics
- Virginia Mason Medical
- Harborview Medical Center & Clinics
- Northwest Hospital and Medical Center & Clinics
- Valley Medical Center & Clinics
- Hall Health Primary Care Center
- General Release Form
- Request for Contact (for providers)