If you're a new client, please complete the following forms and bring them to your first therapy session.
- Client Psychotherapy Intake Form →
- Limits of Confidentiality/Therapy Cancellation Policy →
- Social Media Policy →
If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:
Note: To download Adobe Acrobat Reader for free, click here.
Rates & Insurance
$130 per 50-minute session
Services may be covered in full or in part by your health insurance or employee benefit plan. Please check your coverage carefully by asking the following questions:
- Do I have mental health insurance benefits?
- What is my deductible and has it been met?
- How many sessions per year does my health insurance cover?
- What is the coverage amount per therapy session?
- Is approval required from my primary care physician
- Reduced fee services are available on a limited basis.
Cash, Check and Visa and Mastercard are accepted for payment.
If you do not keep your scheduled therapy appointment with Susan Hammonds-White and you have not notified us at least 24 hours in advance, you will be required to pay the full cost of the session.