Notice of Privacy Practices
Policies of the Practice
Authorization of Release of Protected Health Information (PHI)
No Show Policy
Telemedicine Informed Consent
Treating Minors of Divorced or Separated Parents
Controlled Substances Prescribing Agreement
Initial Comprehensive Psychiatric Evaluation: $350 (1 hour)
Follow Up Medication Management $125 (15min), $200 (30min)
Letters and Completion of Forms: <2 Pages $30; >2 pages $50-$75
Due to liability and complexity of psychiatric illnesses, certain forms are not filled out or letters requiring medical opinions are not provided.
Please contact the office to find out whether your request can be fulfilled. Please fill out all information that you are supposed to fill, before submitting. Completion of letters and forms can take up to 7 business days. So please plan ahead. School Medication Administration Forms will be filled free of charge.
No Show or Cancellation less than 24 hrs: $75 for Medication Management and $150 for Psychiatric.
CIGNA Insurance
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