Good Faith Estimate 

Under Section 2799B-6 of the Public Health Service Act, you are entitled to receive a Good Faith Estimate (GFE) detailing the potential costs of psychotherapy services if you are not enrolled in a health plan, a Federal health care program, or do not intend to file a claim with your insurance. This estimate is provided both orally and in writing upon request or at the time of scheduling services

Important Considerations

• Fee-for-Service Model – If you discontinue therapy at any time, you will not be charged for unbooked sessions, provided the cancellation policy is followed.

• Additional Services – The estimate does not include fees for extended sessions, client-centered advocacy work, or paperwork requests. These services are provided at the client’s request and are only charged with prior notification.

• Non-Binding Estimate – The Good Faith Estimate does not obligate you to obtain services from our practice, nor does it guarantee a specific treatment duration or outcome. You may discontinue treatment at any time.

• Dispute Resolution – If the actual amount charged to you exceeds this estimate by $400 or more, you have the right to initiate a dispute resolution process.

For questions or more information about your right to a Good Faith Estimate, visit http://www.cms.gov/nosurprises or call 800-985-3059.