PAMELA KOHLL

INTIMACY THERAPIST

I'm glad you're here and am excited to see that you're ready to get started.  I promise to be there for you every step of your journey. My goal is to help you grow from your struggles, heal from your pain, and move forward to where you want to be in your life. Below I've included information regarding my practice to help you learn more.  I'm also pleased to now offer teletherapy via Zoom if you reside in California, New York or Nebraska.

I do not take any insurances, but will send you a detailed receipt and you can file it with your insurance company.

Please print and complete the following client forms and bring them to your initial appointment:

If you are late for your appointment you will still have to end on time for the courtesy of my next client and the fee remains the same because your fee is based on the amount of time reserved, not the amount used. I want to hear from you via TEXT at my number 917 574-9034, if you are late or need to cancel your appointment. I require a 48 hour cancellation window or you will be charged for the missed appointment. If you have an appointment on Monday, I will need to hear from you by late Friday, or you will be charged for the missed appointment. IF there is a true emergency, you will not be charged. I prefer not to see you if you are very sick, and will work to try to help you reschedule. Insurance will not reimburse for missed appointments. Insurance may not reimburse for associates or interns either, you will have to check with your insurance company around this. If you miss a session or cancel late, your insurance company will not help you cover the fee for that session. If you have a set session time and you fail to show up or cancel in advance for three consecutive weeks, I will assume you are no longer interested in that time slot and make it available to other clients.

You are responsible for payment of the agreed upon fee for any missed sessions, or cancellations that are not 48 hours advanced notice.  Thank you.

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call me at (917) 574-9034.