Mountain View
Schedule an Appointment:
To schedule an appointment at my Mountain View office please email me, give me a call, or book online by clicking Book Now! In the case of an emergency, please call the toll free Santa Clara County Crisis Line (855)278-4204, dial 911, or go to your local emergency room.
If you are a potential new client, please schedule a FREE phone consultation.
This 15 minute phone consultation is designed to help determine if we would be a good fit to work together.
Cognitive Behavioral Therapy (CBT)
Email: Richard@Feelinggoodinstitute.com
Telephone:(650)567-6496
Feeling Good Institute
2660 Solace Place, Suite D2
Mountain View, CA 94040
Book Now!
*The policies listed here are a brief overview. Please see “Forms” section to read full “Client Informed Consent” document.
PROFESSIONAL FEES:
Fees are as follows:
50-minute Session: $450
50-minute Intake/Initial Appointment: $450
BILLING AND PAYMENTS:
Payment is collected for the first appointment at the time it is booked. Each additional session can be paid at the time the appointment is held. We are able to accept cash, check, or credit cards (visa or mastercard). If your account has not been paid for more than 60 days and arrangements for payment have not been agreed upon, we have the option of using legal means to secure the payment. This may involve hiring a collection agency or going through small claims court. [If such legal action is necessary, its costs will be included in the claim.] In most collection situations, the only information we release regarding a patient’s treatment is his/her name, the nature of services provided, and amount due.
INSURANCE REIMBURSEMENT:
I am not currently listed on any insurance panels, which means that I am an “out-network” for any insurance provider. I will give you a receipt and you are welcome to apply for reimbursement of a portion of the fee through your insurance provider. I cannot guarantee whether your insurance provider will cover this expense. Many carriers will provide only very limited coverage. Please consult with your insurance carrier prior to starting services.
CLIENTS WITH MEDICARE:
I have opted out of Medicare under under §§1128, 1156 or 1892 of the Social Security Act. If you are eligible for Medicare but choose to work with a clinician who has opted out of Medicare, then you will have to complete the Patient’s Contract For Private Care Contract (In the Forms tab). Signing this contract indicates an understanding that you (or your legal guardian or representative) will be solely responsible for all costs of treatment and that you will not seek reimbursement from Medicare. Seeking services from a provider who accepts Medicare may lead to less total cost for you.
Forms:
If you have already completed a phone consultation and have scheduled a first appointment, please print the following documents and bring them to the first appointment. We will use our initial meeting to assess whether we mutually agree to establish a therapeutic relationship.
HIPAA Complaint Forms to complete before your first appointment:
Additional Forms (may be used in the course of treatment):
- Medicare Private Contract (necessary for persons 65 yrs of age or older who qualify for Medicare)
- Release of Information (necessary if you would like me to share information with another person or agency)
Forms for your own Records:
- HIPAA Notice of Privacy Practices (Describing policies to protect your private information. Please download and keep for your own records.)