Therapy Intensive

Intake: $500
One hour session with therapist. Intake includes, but not limited to, collaboration with therapist, prep for intensive and review of workbook

Intensives:
$1,200 Half Day- 3 hours
$2,400 Full Day- 6 hours

After each intensive, you will have the included option of a one-hour follow up session with your therapist. This can be scheduled out a week, at minimum, post intensive.

The following questions will help assess whether the Therapy Intensives are a good fit for you. After completing the form, you will be scheduled a phone consultation to answer any questions and determine the length of your therapy intensive.

Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Private Pay Consent

Intensives are structured as private-pay services that fall outside the scope of covered psychotherapy codes due to their extended length and integrated therapeutic approach. By clicking each box, you are agreeing to each statement.

The service is optional and not required for continued care.

I am opting out of using my insurance for services.

I agree to pay out of pocket.

Have you been hospitalized within the last six months?

Do you have current thoughts of self-harm, suicidal or homicidal ideation?

Are you actively struggling with substance use?

Have you been or are you currently in therapy? If so, how long and do you have a current therapist?

Please share your experiences with therapy.

Has it been beneficial? What have you learned?

Have you participated in any of the following therapy modalities?

Accelerated Resolution Therapy (ART)

Eye Movement Desensitization Reprocessing (EMDR)

Internal Family Systems (IFS) or Parts Work

Somatic Experiencing (SE)

If so, were they helpful?

Please specify modality

What would you like to address in your intensive?

What type of incident do you want to address?

How long ago did incident happen?

What makes you feel like intensives might meet your needs more than traditional weekly therapy? What do you hope to gain? How would you like to feel differently?