171 Front St. Suite 104, Danville, CA
Please bring in signature page to your first appointment.
AGREEMENT OF THERAPY SERVICES (pdf)
DownloadPlease bring to your first appointment.
Client Information Sheet (pdf)
DownloadPlease bring in signature page to your first appointment.
HIPAA NOTICE OF PRIVACY PRACTICES (pdf)
Download$300 for a 45 minute therapy session plus 5 minutes of wrap up/ scheduling. Fees for longer sessions are pro-rated based on same rate. For example, a 75 minute session is $450.
Payment is due at time of your appointment; see below for possible health insurance reimbursement.
Dr. Chambliss does not accept credit cards however payment can be made via check, cash, PayPal, Venmo, or Zelle.
Dr. Chambliss has made a careful decision not to be a participating provider for any managed care programs. However, she can provide each client with a monthly receipt which may be submitted by the client to their insurance company for reimbursement depending on the plan’s policy.
Copyright © 2019 Dr. Amy Chambliss - All Rights Reserved.