Cluff Counseling
Forms and Fees
Please print and complete the New Client Paperwork and bring these forms to your first session. If you were referred by the Federal Aviation Administration (FAA), please only print and complete the FAA Referred Client Paperwork.
Fee Agreement
The billable therapy hour is 50 minutes. If the session extends past the hour, I will endeavor to solicit permission to extend the session and inform you of the rate adjustment for the session. Payment is due at the time of service and will be made via Ivy Pay, a HIPAA compliant mobile payment processing platform. Accepted forms of payment include credit cards, debit cards, FSA or HSA.
Session fees are $200 per 50 minutes for standard therapy services. Aviation professionals and FAA-referred clients pay $225 per therapy 50 minutes due to specialized compliance requirements, enhanced documentation, and coordination with aviation medical professionals. Fees and consent requirements will be confirmed and discussed during your initial consultation.
If you are unable to keep an appointment, you must notify me at least 24 hours prior to your appointment time. If I am unable to answer your call, please leave a voicemail message and your call will be returned within 24 hours.
You are responsible for keeping your scheduled appointments. With the exception of an emergency, you will be billed for all missed appointments that are not canceled at least 24 hours ahead of time.
In instances where a third-party, such as an ecclesiastical leader, has taken responsibility for payment, you must present a letter, signed by the third-party, stating their willingness to pay for services.
Although I am not on any insurance panels, I will be happy to provide a monthly superbill for you to submit to your insurance company, at your request.
I do not provide witness or expert testimonies for court hearings. My clinical expertise is in the therapeutic setting, not legal matters, and I strongly discourage involvement in legal proceedings.