FEE AGREEMENT AND FINANCIAL POLICYFee Agreement and Financial Policy • February 5th, 2021
Please review this Fee Agreement and Financial Policy (the “Agreement and Policy”), which describes my schedule of fees for therapy services, charges not covered by insurance, and additional fees. Please be sure you understand the policies regarding cancelations and missed appointments, methods of payment, insurance reimbursement, and past due accounts. If you have any questions about anything, please ask me prior to signing this Agreement and Policy.
FEE AGREEMENT AND FINANCIAL POLICYFee Agreement and Financial Policy • November 4th, 2020
Please review this Fee Agreement and Financial Policy (the “Agreement and Policy”), which describes my schedule of fees for therapy services, charges not covered by insurance, and additional fees for Karen Muehl Counseling, PLLC (“KMC”). Please be sure you understand the policies regarding cancelations and missed appointments, methods of payment, insurance reimbursement, and past due accounts. If you have any questions about anything, please ask me prior to signing this Agreement and Policy.
FEE AGREEMENT AND FINANCIAL POLICYFee Agreement and Financial Policy • November 15th, 2021
Thank you for choosing Calico Mental Health Associates. Please review this Fee Agreement and Financial Policy which describes our schedule of fees for services and charges not covered by insurance. Please be sure you understand the policies regarding cancelations and missed appointments, methods of payment, insurance reimbursement, and past due accounts. Fees subject to change without notification. Link to fee schedule: https://www.calicomh.com/fee-schedule
FEE AGREEMENT AND FINANCIAL POLICYFee Agreement and Financial Policy • November 14th, 2022
Please review this Fee Agreement and Financial Policy (the “Agreement and Policy”), which describes my schedule of fees for therapy services, charges not covered by insurance, and additional fees for Emilee Conrad Counseling, LLC (“ECC”). Please be sure you understand the policies regarding cancellations and missed appointments, methods of payment, insurance reimbursement, and past due accounts. If you have any questions about anything, please ask me prior to signing this Agreement and Policy.
FEE AGREEMENT AND FINANCIAL POLICYFee Agreement and Financial Policy • March 3rd, 2023
Please review this Fee Agreement and Financial Policy which describes my fees for services and charges not covered by insurance. Please be sure you understand the policies regarding cancelations and missed appointments, methods of payment, insurance reimbursement, and past due accounts. Fees subject to change without notification. Link to fee schedule: www.erinoleary.com/fee- schedule
FEE AGREEMENT AND FINANCIAL POLICYFee Agreement and Financial Policy • February 8th, 2014
Please review this Fee Agreement and Financial Policy (the “Agreement and Policy”), which describes my schedule of fees for therapy services, charges not covered by insurance, and additional fees. Please be sure you understand the policies regarding cancelations and missed appointments, methods of payment, insurance reimbursement, and past due accounts. If you have any questions about anything, please ask me prior to signing this Agreement and Policy.
