for couples, poly partners + individuals
Consent for Treatment (bring the last page only)
please call or text me for current availability to accept new clients at 206.473.9838
I offer both couple/intimate partner and individual sessions. I accept debit and credit cards, cash and checks.
please check with your insurance to verify coverage and that I am provider for your particular plan. Other things to ask your insurance company - do I have a deductible, what's my copay and/or coinsurance, do I need a pre-authorization or referral?
APPLEHEALTH Plans current/established clients only
Intake (2 pages)
PEMBERLEY VANDER LINDEN COUNSELING WEST SEATTLE (ALKI)
Open Minded, Practical and Badass Therapy
Complete the following two forms and bring with you for the first appointment. Filling these out before your appointment lets us spend more time getting to know each other. Each person participating in therapy needs to complete both forms.
The appointment will be about 50 minutes long and we will have time to talk about what is bringing you to therapy and what your goals are. Additionally we'll go over a couple of business things and answer any questions you may have about therapy and my therapy style. I will give you an outline of how I can help you and what I would focus on in our work together. Frequently this first appointment is more of a get acquainted visit and future appointments will work on addressing your goals.
You can use the teal button at the top of the page to connect to my booking service, Acuity to do all the appointment things. I do require a credit card on file to bill copays to. If you are seeking to start services with me, contact me first for an update on my availability.
Appointments are 50 minutes, "aka the clinical hour." For couples I do occasionally recommend a longer appointment depending on need.
My sliding scale is available to existing clients who demonstrate financial hardship. If you are looking for a provider who can accommodate a sliding scale check out Open Path Collective.
206.473.9838 (call/text) email@example.com