Olepta

I understand that I am responsible for the payment of professional services, and that I am expected to pay at the time services are rendered. I understand that if my insurance does not pay that I will be responsible for the fees.
I understand that your fees are as follows:
* copay/deductible in conjunction with insurance contract.
* $150 for 45 minute individual, conjoint, or family session.
* Telephone discussions not pertaining to scheduling (i.e., consultations) are billed at prorated amount based on the above fee schedule.
* Fees may be subject to change.

I understand that I will be billed for canceled appointments, unless I have given 2 full business days notice of the cancellation. I also understand that it is my responsibility to reschedule an appointment that I have canceled.