Fees and Confidentiality




  • Fee

    $175 per session. However, in these harsh economic times, I have incorporated a sliding scale as well, which is based on your income and ability to pay. Visa, Mastercard, American Express and Discover cards accepted.

  • Insurance

    You are responsible for paying your bill at the end of each month. At that time I will provide you with an invoice to submit to your insurance company for reimbursement. P.P.O.’s accepted. I am an out of network provider.

  • Cancellations


    Your appointment time is reserved for you. You are responsible for paying for that time unless you can make arrangements with me within 24 hours ahead of time to reschedule for another hour during the same week, assuming it is available.

  • Confidentiality


    In general, the law protects the confidentiality of all communications between a client and a psychotherapist. Information is not disclosed without written permission. However, there are number of exceptions to this rule.

Exceptions include:


~ Suspected child abuse or dependent adult or elder abuse. The therapist is required by law to report this to the appropriate authorities immediately by phone and in written form within 36 hours.

~ If a client is threatening serious bodily harm to another person. The therapist must notify the police and inform the intended victim.

~ If a client intends to harm himself or herself. The therapist will make every effort to enlist their cooperation in insuring their safety. If they do not cooperate, further measures may be taken without their permission in order to ensure their safety.

IMPORTANT!

Please print and fill out these forms prior to your first appointment.

Microsoft Word Version (.doc) Microsoft Word Version (.doc)


Your Name (required)

Your Email (required)

Subject

Your Message

IMPORTANT!

Please print and fill out these forms prior to your first appointment.

Service Area

Mim Collins Licensed Marriage and Family Therapy serves the San Fernando Valley Communities of Valley Village, Studio City, North Hollywood, Van Nuys, Sherman Oaks, Burbank, Pasadena, Encino, Toluca Lake, Valley Glen, Sun Valley, Panorama City, Tarzana, and Lake Balboa.

Contact

Mim Collins, Psy.D., M.F.T.
Office in Valley Village
Phone: (818) 763-8222
Contact
www.mimcollinstherapy.com
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