Forms

The following forms provide information about my professional credentials, rules and regulations specific to counseling. These forms also detail my business polices as well as your rights as a client. Please note that there are two documents for individual clients, one for adults and one for children under the age of 18. With adolescents, I have found it helpful at times to leave the office (i.e. - go for a walk, throw a frisbee or football, etc.) as a way of building relationship and rapport, particularly with males. If parents are comfortable with this mode of counseling, please complete the release form included.

Adult Disclosure Form

Child Disclosure & Release Forms

Couples Form


Fees

20-minute initial consultations are free. These meetings can be either by phone or in-person and are a great way for you to meet Josh and see if he might be a fit for you or your teenager's needs. 

Standard Individual Adult, Child and Couples fees are $115 per 50-minute session. For a 1 1/2 hour (80 minutes) session, the fee is $155.

A reduced fee is offered during a limited number of weekly appointment slots. 

Payment is due at the time of therapy. Cash or check (payable to Belay CC), as well as major credit cards and Paypal are acceptable forms of payment. 

Cancellation Policy

Full session fees are collected for cancellations made within 24 hours. Cancellations made outside this 24-hour window may be rescheduled for any reason with no penalty. This cancellation policy does not apply for serious or contagious illnesses and emergencies. Please communicate a cancellation more than 24 hours prior to your appointment.


Insurance

Belay Counseling & Coaching, LLC. does not bill health insurance providers. However, some insurance companies will accept receipts for psychotherapy for your reimbursement. Before beginning therapy, please contact your health care provider to obtain any pertinent requirements for reimbursement.