Helpful Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.

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.

Cancellation Policy
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.


Privacy & Policy

Confidentiality & Privacy Policy, Including Social Media

The law protects the relationship between a client and a psychotherapist, and information cannot be disclosed without written permission.

Exceptions include:

  • Suspected child abuse or dependant adult or elder abuse, for which I am required by law to report this to the appropriate authorities immediately.
  • If a client is threatening serious bodily harm to another person/s, I must notify the police and inform the intended victim.
  • If a client intends to harm himself or herself, I will make every effort to enlist their cooperation in ensuring their safety. If they do not cooperate, I will take further measures without their permission that are provided to me by law in order to ensure their safety.

Private Practice Social Media Policy

 This document outlines my office policies related to the use of Social Media, including use of the internet, email, texting and any other media methodologies used in today’s world.

As your mental health provider, it is my responsibility to do my utmost to preserve the confidentiality and the boundaries of our relationship.  In this electronic age it has become very common to make use of varied means of communication; however, you need to know the implications of such use so that you are able to make an informed decision about whether you wish to use these methodologies.

If you have any questions about anything in this document, I encourage you to bring up your concerns.  As new technology develops and the Internet changes, there may be times when I need to update this policy.  If I do so, I will notify you in writing and make sure that you have a copy of the updated policy.


I do not currently accept friend or contact requests from current clients on any social networking sites (Facebook, LinkedIn, etc.).  I believe that doing so can compromise both your confidentiality and our respective privacy.  It may also blur the boundaries of our therapeutic relationship.  If our therapeutic relationship is concluded and time has passed, I may in some circumstances accept such a connection.

I keep a Facebook page for my professional practice to allow people to share my blog posts and practice updates.  You are welcome to view my professional Facebook Page and read or share articles posted there, but I do not accept clients as Friends or Fans of this page.  Accepting clients as friends increases the likelihood of compromised client confidentiality.  

I publish a blog at times on my website.  I have no expectation that you as a client will want to follow my blog.  However, if you use an easily recognizable name to do so, and I happen to notice that you have followed me there, we may briefly discuss it and its potential impact on our working relationship.

Emailing and Texting

Please be aware that if you email or text me, first, I cannot guarantee the confidentiality of these communications, and second, I cannot guarantee that I will see them in a timely fashion.  The best way to contact me continues to be by phone.  You should also know that email/text can be considered part of your legal record and will need to be documented and archived in your chart. Emailing about administrative issues (scheduling or modifying appointments) is ok.  I use an encrypted email for my practice; however, you need to know that these logs are retained by your and my internet service provider.

Search Engines

It is not a regular part of my practice to search for clients on Google or Facebook or on other search engines.  If you are in crisis and I have reason to believe that you are in danger and have been unable to reach you, I might use a search engine in that instance.  If so, I will discuss it with you when we meet.

In Conclusion

Social media and technology are part of the world we live in today.  Many of us are very accustomed to using these forms of media for communication.  However, these forms do carry risks; the major risks are that privacy can be compromised.  I am doing everything I can to mitigate those risks, but I need for you to know that, if you choose to use email or text, I cannot guarantee the absolute confidentiality of those processes.