Before we can have our first appointment, we need some paperwork from you.

Please note that a failure to return your paperwork within 24 hours of your appointment will result in the need to reschedule. We cannot hold your first appointment without it.

Some of this paperwork is available for download on the website below. If the paperwork you need to fill out is not located here, please contact our office at or 717-394-3994 to obtain another copy.


HIPAA Information

Fees / Cancellation Policy

This counseling practice operates on a fee-for-service basis. The cost of professional services is evaluated annually and posted no later than January 1.

Fee Structure for 2022
Psychiatric Evaluation without medication (Biopsychosocial assessment) / 90791 $225
Psychotherapy 53-60 minutes / 90837 $190
Psychotherapy 45 minutes / 90834 $150
Psychotherapy 30 minutes / 90832 $130
Psychotherapy Family session with/out client / 90847/90846 $200
Group session (Closed group format - minimum of 6 participants) $50
Educational Support Services $30 (open group format)
Documentation to any officer of the court $200
Testimony $350 per hour
Disability Documentation/Evaluation $200
Concierge Counseling Price per contract requirements

Licensed Professional Counselors and Professional Counselors are billed at separate rates.

Professional Counselors are billed as follows
90791 $95.00
90834/90837/90847 $80.00

The majority of sessions are billed to insurances at the 90837 Therapeutic hour, which approximates to 53 minutes face to face time with the therapist.

Efforts are made to help clients access their health insurance benefits for reimbursement for out-of-pocket expenses. Insurance reimbursement for clinical services offered by Licensed Professional Counselors varies from state to state and from carrier to carrier. Payment for services is required when those services are rendered unless alternate provisions have been made in advance. Payment for services by credit/debit card is available. These services appear as “ACRS” on your statement. Scheduled sessions must be cancelled by telephone at least 24 hours in advance or a $150.00 session fee will be assessed. This does not apply to situations deemed to be emergency in nature. Clinical services can be terminated as a result of nonpayment of fees under certain conditions (ACA Code of Ethics, 2005. A.10.d). For individuals with insurance coverage, all co-payments must be paid when services are rendered. A $25 fee will be charged for each returned check along with any prior balance owed.

Responsibility for Payment

Clients are responsible for payment of services when services are rendered except in situations where third-party benefits are approved and forthcoming. As an approved provider for some insurance plans, the therapist has entered into agreements for rate levels that may be different from the posted fee-for-services. In situations such as these, the client is responsible for only the co-payment determined by the insurance plan. Reasonable efforts will be made to accommodate the financial situation of individual clients. Contractual payment plans are considered on a case-by-case basis.

Accounts will become delinquent after 30 days of non-payment unless payments are being made through an approved third-party. A 2.5% late fee will be assessed on the principle for every 30 days the payment remains delinquent. When the payment delinquency extends beyond 120 days, the account will be forwarded to a local collection agency for resolution. Any legal fees or collection fees associated with this action will become the responsibility of the client. Delinquent accounts beyond 120 days will also be reported to local and national credit bureaus.


What is Mental Health?

Mental Health is comprised of our perception of our beliefs, feelings, and our behaviors. These perceptions, thoughts, feelings, and behaviors are usually a combination of psychological or emotional cues, inherited traits and/or genes, and any exposure to environmental cues before, and/or after birth.

Mental Health and Symptomology: How are they common and connected are they?

According to the National Alliance on Mental Illness (NAMI) 1 in 5 adults in America experience mental illness in a year and 1 in 5 children between the ages of 13 and 18. Common types of symptoms include but are not exclusive are: Depression Anxiety Suicidal ideations Insomnia Feeling hopeless/ helpless Anger, irritability, agitation, Homicidal ideations Isolation, withdrawal from friends, family, peers. Inability to manage grief, loss, or profound sadness Aggression Tearful, sobbing or excessive crying. Loss of appetite Flashbacks Nightmares Imminent dangers to self or others Confusion, loss of concentration Crisis or acting out behavior.

Can an individual recover from mental illness?

The long of the short of it is ...Yes, while there might not be a way to prevent all mental illness from occurring, there are ways to mitigate long term effects of mental illness. Speaking with a counselor, having an evaluation, and psychoeducation.