Terapia de salud mental asequible en Illinois y Indiana
Aceptamos Medicaid y Medicare

Please read and agree to the following terms before submitting your form. I understand therapy is provided by secure video and audio. I can stop telehealth sessions at any time. Sessions are not recorded and I agree not to record them. My privacy is protected, but internet-based sessions may have some risks, e.g., dropped calls, unauthorized access. I agree to follow backup plans if the video connection fails. My therapist may contact emergency services if needed during a session. Cancellation Policy I agree to cancel at least 24 hours before my appointment. I understand I will be charged $65 for late cancellations and $130 for no-shows. Emergencies or illness may waive these fees. Payment Policy I will keep a credit/debit card on file for balances. Insurance co-pays and balances not covered are my responsibility and due within 30 days. Self-pay clients must pay at the time of service. By signing, I agree to these terms.