Payment is expected at each session unless other arrangements have been made in advance. You are
responsible for payment for all services rendered either by Paypal, check or cash. All
checks or Paypal will be paid to Elisa Elkin-Cleary.
The current fee for psychotherapy with Elisa Elkin-Cleary is $ per hour.
A session is generally 60 minutes in length. Longer sessions are charged as a prorated fee.
This practice is an Out of Network Provider. I do not bill your insurance company and therefore
payment is due at each session. However, I will provide a "super bill" if you are eligible for
reimbursement from your insurance company. Services may be covered in full or in part by your health
insurance company or employee benefit plan. Sliding Scale and fee
increases are determined at Elisa Elkin-Cleary's discretion.
For sliding scale agreements and contract fees, a separate form will be provided and signed at the initial
Occasionally, I may increase my standard fee. If you are in therapy when an increase is to occur, you will
be notified in advance. At that time, your fee will be adjusted to the new fee, this fee agreement will be
terminated, and you will be asked to sign a new agreement which reflects the new fee. Any prepaid
sessions or original sliding scale fee arrangements will continue to be honored at the original rate until
they are used.
I have read and understood the above fee agreement, and I agree to abide by its terms.