Billing Details
As a pre-licensed professional, I cannot accept insurance. However, ask me about my sliding scale -- which closely resembles your typical co-pay.
Email me or call me at 484-202-0629 for more information.
Email me or call me at 484-202-0629 for more information.
Forms
Please print, sign, and scan (or take a photo of) these forms and return them to me via email or snail mail (see footer).
- Intro Form - Demographics (PDF)
- Consent Form (PDF)
- Notice of Privacy Practices (PDF)
- Release of Information (PDF)
If you would prefer to have the forms physically mailed to you,
please let me know.
