PSYCHOTHERAPY and counseling for individuals  and Couples – Corvallis OR

Seth Bernstein, Ph.D.

 

FORMS TO BE COMPLETED and sent to dr. bernstein before THE FIRST SESSION is scheduled


    Consent To Time-Limited Treatment Form


    COMPLETE AND SEND TO SETH BERNSTEIN BY MAIL OR EMAIL.

OTHER Forms To be reviewed (NOT SIGNED) prioR to the first session


    Office Policy: Clients with In-Network* Insurance Coverage:

       *Blue Cross, MODA, Pacific Source, IHN, Samaritan Choice

 

   Office Policy: Clients with Out-Of-Network Insurance Coverage


   Office Policies: Self-pay Clients


   Privacy Policy


​   Treatment Goal Setting Tool


FORMS TO BE COMPLETED AND BROUGHT TO THE FIRST SESSION


 Client Information Form


BRING YOUR INSURANCE CARD TO YOUR FIRST APPOINTMENT AND CONTACT YOUR INSURANCE COMPANY TO VERIFY IF YOU HAVE A DEDUCTIBLE TO PAY AND WHAT YOUR CO-PAYMENT OR CO-INSURANCE AMOUNT IS FOR PSYCHOTHERAPY.

Form TO BE COMPLETED BETWEEN FIRST AND SECOND SESSION


      Client History Form     



PSYCHOTHERAPY and counseling for individuals  and Couples – Corvallis OR

Seth Bernstein, Ph.D.