Forms&FeesInformation

RequiredForms

New Clients should complete each of the following forms and bring them to the first session:

PDF File Therapeutic Contract
PDF File Notice of Privacy Practices
PDF File Credit Card Authorization
PDF File Confidential Client Information Form
PDF File Client Questionnaire

Please Note: If you are seeing me for Couples Therapy, please complete one copy of the Therapeutic Contract, Notice of Privacy Practices, and Credit Card Authorization per couple; and one Client Information Form and Client Questionnaire per individual.

Fees

I charge $110 for each 50-minute session.  Payment is expected at the beginning of each therapy session and I accept cash, check and all major credit cards.

I am an in-network provider for Aetna.  If you have a PPO or POS plan with another insurance carrier you may be able to get partial reimbursement for the session fees that you pay me.  I can provide you with a detailed receipt that you can submit to them if this is the case.  Please contact your health insurance company to verify your benefits. 

CancellationPolicy

I consider therapy to be a very serious commitment, both on my part and on yours. I attempt to offer you the same appointment time each week and reserve the session time specifically for you.  As I do not accept walk-ins, if an appointment goes unattended, I am unable to fill that appointment slot with a client in my waiting room.  Please be courteous and notify me as soon as possible if you need to cancel or reschedule.

If a cancellation is received less than 24 hours before the appointment time, or if you fail to show for an appointment, you will be charged the full fee for the length of time that was reserved.

If we are able to reschedule your appointment to another time during the same week, this late-cancellation fee will be waived.

 

Schedule your appointment today!Megan Torrey-Payne, LCSW
1139 N. Brand Blvd. Suite A
Glendale, CA 91202

Office: 818-259-8372