Paperwork and Appointments
Costs and Insurance
The fee for a 1-hour counseling appointment is $150. Insurance typically covers if you have… I will no longer be the preferred provider with these insurances: Blue Cross, Blue Shield, and First Choice. If you have another insurance they may cover me at an “out of network” rate. At this time I do not offer a sliding scale. I do other therapists I can refer who offer this. Hours that I offer counseling are Monday through Friday 9am to 6pm. On rare occasions I will stay a little later.
COUNSELING FORM Counseling Form (PDF)
This form contains: Counseling Agreement (client rights, counselor’s credentials, confidentiality, payment and directions to the office) If you have not filled out the paperwork try to be 15 minutes early to fill it out. There are copies in the waiting room. If you have filled it out at home still give yourself plenty of time to get their about 5 minutes early so you can get some tea and relax before coming to the session. You will get more out of the session when you are relaxed and not rushed.
Neurofeedback Form – This form describes neurofeedback and gives consent to the neurofeedback training.
EXTRA INDIVIDUAL FORMS You do not need to print these out if you printed out the above Counseling Form. These are insurance forms and for me to talk to other people
Insurance Information (in MS Word) Insurance Information (in PDF) (This is fill-in-able) This form allows me to contact your insurance company regarding coverage. You can sign it and fax it to me if you want.
“Disclosure Form to talk with other Professionals” (in PDF) This form, after signing it, allows me to talk with another professionals about your care.
“Notice of Privacy Policy” (in MS Word) “Notice of Privacy Policy” (in PDF) This describes our privacy policies according to HIPPA
Directions to Erik Bohlin’s Office (in MSWord)