Insurance Financial Policy and Fee Agreement Sample Contracts

Contract
Insurance Financial Policy and Fee Agreement • February 8th, 2022

Fee: My fee for appointments 55-60 minutes in length is $120.00 for individuals and/or couples. Insurance only covers sessions that are 60 minutes or less. I understand that at times, you as a client may need additional time. I would be happy to set up an appointment with you the following business day in order to continue your session as well as remain in compliance with the insurance requirements.

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Contract
Insurance Financial Policy and Fee Agreement • August 31st, 2024

Fee: My fee for appointments 55-60 minutes in length is $150.00 for individuals and/or couples. Insurance only covers sessions that are 60 minutes or less. I understand that at times, you as a client may need additional time. I would be happy to set up an appointment with you the following business day in order to continue your session as well as remain in compliance with the insurance requirements. Rates are subject to change but notice will be given.

Contract
Insurance Financial Policy and Fee Agreement • September 8th, 2021

Fee: My fee for appointments 55 minutes in length is $120.00 for individuals and/or couples. Insurance only covers sessions that are 60 minutes or less. I understand that at times, you as a client may need additional time. I would be happy to set up an appointment with you the following business day in order to continue your session as well as remain in compliance with the insurance requirements.

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