The following forms are offered online so that they can be completed in the convenience of your own home or office. Please download the requested forms, fill in the required information, and bring them with you to your first session.
- Family Data Form
- Disclosure Statement
- Authorization to Request
- Corissa JS Gold – MFA MA LPC ATR – Brochure 2011
- Corissa’s CV 12-2015
PAYMENTS: Payment is due at the time of service, unless otherwise agreed in advance. Please come prepared to pay with cash, check, or credit card.
INSURANCE: Although I do not accept insurance, I provide a Receipt of Services Rendered for each session that you can submit to your insurance provider.
LATE-CANCELLATION/NO-SHOW POLICY: For no-shows and appointments not cancelled 24 hours in advance clients are responsible for the session fee.
INTRODUCTORY PHONE CONSULATATION: You may arrange one 30-minute introduction phone consultation at no charge. Future phone calls (outside scheduled sessions) will be prorated for the length of the call.
To make an online payment: