The Evergreen Clinic in Kirkland
Rates & Practices policies
Please note that my work at The Evergreen Clinic in Kirkland is managed by the clinic directly and has differing polices and practices that include forms, scheduling, billing & fees, and insurance coverage. The following information may not be complete or reflect your benefits. Please call the clinic directly for any scheduling or further questions you may have about my services at the clinic.
Adult and Child Therapy Rates and Insurance
At the Evergreen clinic, I am paneled as a preferred provider for most major insurances. However insurance plans may vary in coverage and you are responsible to know your benefits to avoid unexpected cost. Plans accepted:
Regence, Keiser Permanente Access PPO
Kaiser Permanente Core HMO with Authorization from Kaiser Permanente
Aetna & United Behavioral Health if your insurance allows out-of-network providers
Rates for Therapy Services
Individual therapy services: $150 for 1 hour session
Initial intake sessions $200 for 1 hour session
When you make a therapy or coaching appointment, the time is specifically reserved for you. In the event that you need to cancel an appointment or reschedule, please notify me as early in advance as possible (at least 24 hours) so I may utilize the appointment time for other clients who may be waiting. In cases where you fail to give adequate notice, I will need to bill you for the full session fee (insurance will not cover cancellation or missed fees for therapy sessions).
Payment can be made using check or credit card, made payable to The Evergreen Clinic
Forms for New Adult Clients
If you're a new client, it would be very helpful for you to complete the first three forms, New Client Information, Adult Health Intake and the Financial Disclosure and bring it with you to your appointment. If you are a new or existing client and would like me to share or coordinate with another provider or person, please complete the Consent for Exchange of Information.
Forms for New Child and Teen Clients
It would be very helpful for you to complete the first two forms: the New Client Information and the Minor Health Intake forms. Bring these forms with you to your child's first appointment.
If you would like me to share or coordinate with another provider or person, please complete the Consent for Exchange of Information. (Children over 13 must sign to allow the sharing of information, including their parents.)
If children are in a two-home family, I require both parents permission and signature on the Guidelines for Child Therapy for Two-Home Families (choose the appropriate form for your child's age)
If requested, please provide a current copy of your parenting plan.