Tiffany Shanks MA, LMFT

Rates
The standard self-pay rate for an individual session is $110 for a 45-minute hour. The standard self-pay rate for a couple or family session is $160 for a 75-minute hour. Due to the nature of the initial (intake) session, the individual intake rate is $135 and the couple or family intake rate is $185. A sliding scale rate is available on a limited basis. Fees for services are due at your therapy appointment. Cash, check payable to me, and the following credit cards: Visa, Mastercard, American Express and Discover, are accepted

Insurance

Unfortunately, I do not accept insurance. However, I may be able to see you as an out-of-network provider. Please contact your insurance company about its policy regarding out-of-network providers. I can provide monthly Summary of Fees statements. Based on your insurance company, you may be able to submit this statement for reimbursement consideration. Although many insurance companies reimburse for therapy with proof of payment, I cannot guarantee reimbursement.

Cancellation and Missed Appointment Policy
Appointments cancelled or rescheduled within less than 24 hours notice are charged at 50% of your regular session fee. No call/no show sessions are charged at 100% of your regular session fee.

Forms

Please print and complete the forms below and bring to initial session
Client Intake Form
Informed Consent for Treatment
Bilateral Release of Confidential Information
Acknowledgement of Receipt of Notice of Privacy Practices

For your records only
Notice of Privacy Practices

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