Patient Information (and Forms)

Introduction & Important Information

Please be sure to read this whole form very carefully, then print out a copy (click blue button at very bottom of page), then sign and bring or mail the form to the Scarsdale office. There may also be other forms that are important for you to read, sign and submit. Each of those forms has its own clickable button to produce a printable version.

Initial Evaluation Sessions

In order to provide the most useful and thorough information, most patients begin with a three session evaluation (sometimes two or four), each one for 45 minutes, typically within 10 days or less.

The first session starts with empathic listening to your concerns, described in your own way.  Then, many questions will explore the basics of your emotional symptoms, work and family issues, medical history, family history and significant life events.  This is very important for understanding diagnoses, relationship and life problems, and for discussing possible solutions. 

Evaluation sessions are essential, but are very different in style than subsequent psychotherapy sessions (far fewer questions to answer) or medication sessions (more focused on symptoms and medication).

Please complete and send the Medical Information Release Form if you would like me to talk with relatives or other doctors. If you have been in a psychiatric hospital, please call the hospital to request that your records (admission note, discharge note, psychosocial summary) be sent as soon as possible by US Mail (only), to the Scarsdale office. Some hospitals may require use of their own release forms.

Medical Information Release Form here:

Payment

Payment is your personal responsibility, and due on receipt of invoice. Although payment by Zelle transfer through your online bank account is easy, reliable and preferred, checks and credit cards are also acceptable.

Existing and future fees can be maintained or modified by mutual consent. Under the New York State No Surprises Act, the usual fee for new patients is $425 for any 45 minute scheduled clinical appointment, and $200 for any 15 - 20 minute scheduled clinical appointment. Total costs over time depend on clinical needs, goals and response that determine treatment frequency and duration.

A completed Automatic Payment by Credit Card Agreement is requested, for use in the event of missing payment. The form can be brought in by the patient, or mailed to the Scarsdale address. You can also send your CVV code separately: by voice mail, during session, or in a separate envelope.

Appointment & Cancellation

Appointments can be requested by leaving a voice mail message with your full name, telephone number, and suggested callback times.  As is common practice in psychiatry and other mental health care, a scheduled full appointment means that 45 minutes of time has been reserved for you only, at an agreed time and date.

For ongoing psychotherapy there are specific days and times reserved for your sessions.  When reserved sessions are missed or cancelled, the missed session incurs the usual charge. The missed session charge can often be avoided with an early call that allows rescheduling that week, or seeing another patient in your place.

In the case of occasional or infrequent sessions, please give at least 72 hours notice, to avoid a usual charge.  If you are unable to attend any scheduled appointment, please leave a voice mail as soon as possible, so that other arrangements can be explored.

Insurance

Like many area psychiatrists, this office does not participate in private or public insurance plans, and has opted-out of Medicare. If you are covered by Medicare, they require that you complete and mail the Medicare Private Contract to the Scarsdale office.

Many private insurance plans include out-of-network coverage, which may reimburse you for part of the cost. We are happy to help with out-of-network claims. It is important to find out if your plan: has a separate out-of-network deductible, what is the maximum dollar amount per session that they will consider (the entire fee in some cases), and what percentage of that amount they might reimburse to you after the deductible (commonly between 40% and 80%). Always check your bill carefully, and let us know if you have any concerns or questions.

Patient Information Form (and other Forms)

Please read very carefully, then download the Patient Information Form (and all other relevant Forms), and then bring signed and dated copies of the Forms to your first appointment. For Telehealth, complete and promptly mail each Form to the Scarsdale address.