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Welcome to Forward Edge Services

Welcome to Forward Edge Services

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17Questions

HIPAA

Compliance

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    FOR PATIENTS UNDER THE AGE OF 18 ONLY
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    FOR THOSE SEEKING COUPLES' COUNSELING ONLY
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    Please Select
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    • Afghanistan
    • Albania
    • Algeria
    • American Samoa
    • Andorra
    • Angola
    • Anguilla
    • Antigua and Barbuda
    • Argentina
    • Armenia
    • Aruba
    • Australia
    • Austria
    • Azerbaijan
    • The Bahamas
    • Bahrain
    • Bangladesh
    • Barbados
    • Belarus
    • Belgium
    • Belize
    • Benin
    • Bermuda
    • Bhutan
    • Bolivia
    • Bosnia and Herzegovina
    • Botswana
    • Brazil
    • Brunei
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    • Burkina Faso
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    • Cambodia
    • Cameroon
    • Canada
    • Cape Verde
    • Cayman Islands
    • Central African Republic
    • Chad
    • Chile
    • China
    • Christmas Island
    • Cocos (Keeling) Islands
    • Colombia
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    • Cote d'Ivoire
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    • Cuba
    • Curaçao
    • Cyprus
    • Czech Republic
    • Democratic Republic of the Congo
    • Denmark
    • Djibouti
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    • El Salvador
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    • Estonia
    • Ethiopia
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    • Namibia
    • Nauru
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    • Netherlands
    • Netherlands Antilles
    • New Caledonia
    • New Zealand
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    • Niger
    • Nigeria
    • Niue
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    • Turkish Republic of Northern Cyprus
    • Northern Mariana
    • Norway
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    • Pakistan
    • Palau
    • Palestine
    • Panama
    • Papua New Guinea
    • Paraguay
    • Peru
    • Philippines
    • Pitcairn Islands
    • Poland
    • Portugal
    • Puerto Rico
    • Qatar
    • Republic of the Congo
    • Romania
    • Russia
    • Rwanda
    • Saint Barthelemy
    • Saint Helena
    • Saint Kitts and Nevis
    • Saint Lucia
    • Saint Martin
    • Saint Pierre and Miquelon
    • Saint Vincent and the Grenadines
    • Samoa
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    • Sao Tome and Principe
    • Saudi Arabia
    • Senegal
    • Serbia
    • Seychelles
    • Sierra Leone
    • Singapore
    • Slovakia
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    • Solomon Islands
    • Somalia
    • Somaliland
    • South Africa
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    • Spain
    • Sri Lanka
    • Sudan
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    • Svalbard
    • eSwatini
    • Sweden
    • Switzerland
    • Syria
    • Taiwan
    • Tajikistan
    • Tanzania
    • Thailand
    • Timor-Leste
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    • Tokelau
    • Tonga
    • Transnistria Pridnestrovie
    • Trinidad and Tobago
    • Tristan da Cunha
    • Tunisia
    • Turkey
    • Turkmenistan
    • Turks and Caicos Islands
    • Tuvalu
    • Uganda
    • Ukraine
    • United Arab Emirates
    • United Kingdom
    • United States
    • Uruguay
    • Uzbekistan
    • Vanuatu
    • Vatican City
    • Venezuela
    • Vietnam
    • British Virgin Islands
    • Isle of Man
    • US Virgin Islands
    • Wallis and Futuna
    • Western Sahara
    • Yemen
    • Zambia
    • Zimbabwe
    • Other
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    THERAPY AGREEMENT 

    Please review each of the following sections carefully, as they contain important information regarding the therapy process. If you have any questions about any of the information here, you can address them either directly with your therapist or with Dr. Kate Smaller: kate@forwardedgeservices.com. We look forward to getting you started!

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    PAYMENT INFORMATION 

     

    The regular fee for service at FES is $150 per 45-50 minute therapy session. 

    INSURANCE:

    We recognize that beginning therapy is a big step, and it can be financially daunting. All therapists at FES are out-of-network providers, meaning we do not accept or work directly with ANY insurance plan. Many plans will reimburse for some % of out-of-network care, but you would have to check with your insurance as that is between you and them. 

    All patients are required to keep a card on file that will be charged on the day of session. At the end of each month, we will provide you with a statement of charges you are welcome to submit to your insurance for potential reimbursement. 

    To better serve our patients, we also have some programs in place for those in need of financial assistance: 

    SLIDING SCALE: 

    We reserve a limited number of slots for therapy at reduced fees, and those are distributed on the basis of need and availability. If you would like to request an application for a reduced fee and you haven't already done so, please contact Dr. Kate Smaller. 

    PROJECT REALIZE:

    Project Realize is a non-profit organization we created to help supplement treatment for those in need of more substantial finanical assistance. Again, if you would like an application for Project Realize and have not already requested it, please contact Dr. Kate Smaller. 

    Regardless of fee, all patients are required to keep a credit, debit or HSA card on file. That card will be charged automatically on the day of session at the rate agreed upon. 

     ALL PATIENTS ASSUME FULL RESPONSIBILITY FOR PAYMENT.

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    The regular fee for service is $150 per session. If you need to explore your options and haven't already done so, please contact Dr. Kate Smaller. Otherwise, please enter the fee you understand will be charged to your card for each session.
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    CREDIT, DEBIT, OR HSA CARD TO BE CHARGED AUTOMATICALLY AT TIME OF EACH SESSION OR CANCELLATION
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    By signing here, you indicate that you have received, read, and understand all of the information presented above, including the Notice of HIPAA Privacy Policy, Consent to Psychotherapy, Consent to use of Telehealth, Payment Authorization, and Cancellation Policy. If you have any questions, you can contact Dr. Kate Smaller at kate@forwardedgeservcies.com. You agree to all of the policies, terms, and conditions outlined above. Thank you.
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