Forms

This page contains the necessary links to download (click red square button) forms prior to your initial session.  Please review the Informed Consent and HIPPA Privacy Practice Notice prior to your first session (NOTE: there is no need to print these out!).

 

Adult and couple clients: Please complete and print out the Adult Biographical Info Form.

 

For child clients: Guardians, please complete the Child Personal History Form

 

Please bring the completed intake forms to your initial session.

Cancellation Policy

 

Once an appointment is scheduled, you will be responsible for the session fee unless you provide 2 business days advance notice of cancellation. It is important to note that insurance companies do not provide reimbursement for cancelled sessions.

If it is possible, your therapist will try to find another time to reschedule the appointment.

Payment

 

We are in-network for the following insurance plans: UnitedHealthcare, Oxford, UMR.

 

We are also able to provide a sliding scale based on income for services that are not covered by your insurance.

 

Please call 347-696-1672 to speak with Dr. Bell to determine the best payment option for you.

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