Application Screening & Intake Packets

Adult/Parent Screening and Signature Forms!AodoNwAEZsjtjNIOuQjLKAl3dsfWwg?e=NmpOfc s

Child Screening Application!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.

- Financial Information