Before utilizing Telehealth services, please download, print, sign, scan and then email/mail/fax
or hand-deliver the Telehealth Informed Consent form to my office. This is required in order to utilize Telehealth services
in my practice. Please note: Telehealth is not guaranteed to be a covered service with all insurance plans.
I will bill your insurance, however, it is ultimately your responsibility to call your insurance plan to verify coverage for
this service. You may be required to pay out of pocket if this service is not covered under your particular plan. Feel free
to ask any questions about this service before utilizing Telehealth for counseling sessions.
