Application Screening & Intake Packets
Adult/Parent Screening and Signature Forms
https://1drv.ms/w/s!AodoNwAEZsjtjNIOuQjLKAl3dsfWwg?e=NmpOfc s
Child Screening Application
https://1drv.ms/w/s!AodoNwAEZsjtjNBWVpNHQKUmgZ0Pmg?e=Xk57JZ
- Possible Assessments/Questionnaires Include trauma assessments, attachment styles, parenting styles, relationships, mental health, drug and alcohol, self-harm, etc as may apply
Intake Process
Step One:
The client calls for a consult appointment
o Client Information Packet is completed
o Client returns the application with a non-refundable intake Fee of $75 (self-pay only)
Insurance approval is obtained as applies
o Note: If relationship/group or family sessions, all persons must complete their own paperwork and submit it prior to moving to the next step. ***
Step Two
o Client Questionnaire(s)/ Assessments
o Client Completes Proposed Questionnaire/Assessments
o Client and clinician meet to establish a treatment plan and potential workbook
o Self-pay client pays $125 flat fee non -refundable Assessment Compilation. Each assessment has an additional fee to complete the report.
Individual Sessions: Coaching $100 an hour; Trauma Counseling starts at $150 an hour; Insurance in Oregon Potential. (Pacific Source) Sliding Scale Fee negotiable.
Couples Sessions: Prepare & Enrich (10-12 sessions)- $150 an hour. Other expenses include the assessment fee and workbook paid to the Prepare & Enrich Program.
Group fees as described per group
Other fees that may apply include but are not limited to mileage, copies, phone/email communication, additional assessments, assessment reports, and resource workbooks.
