Welcome! Prior to starting services with Ready Set GO Therapy, we ask you to provide us with some information.  This information will help us to better understand your child, and to most effectively meet the needs of your child and your family.   In this packet, you will also find a description of our services and policies.  Enclosed are the following: 

• Registration Form
• Notice of Privacy Policies and Procedures
• Privacy Policies and Procedures Receipt and Consent
• Parent Policies
• Service Agreement
• Release of Information

Please keep the Notice of Privacy Policies, Parent Policies and Procedures, and a copy of the Service Agreement for your records.  Providing this information as soon as possible prior to your child’s session will help us to prepare appropriately for the first meeting with your child.  If you have any questions, please call us at (415) 339-8800.  We look forward to meeting you! 

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Please include any services such as OT's, Speech therapist, Behavior therapists, Psychologists, Family Therapists, Learning Specialists.

Ready Set GO Therapy, Inc. respects the confidentiality of its clients (child and legal parent/caregiver) and will maintain the privacy of your health information by all applicable federal and state laws. Ready Set GO Therapy will implement the following privacy policies and procedures: 
 
Treatment:   We may use and disclose your child’s health information as part of assessment and intervention procedures.  If a non-parent caregiver is present at your child’s therapy session, consent is implied to discuss basic components of the treatment session, answer questions, and provide recommendations and/or home program suggestions. If you prefer to limit communication with a non-parent caregiver in your child’s session, please let your therapist know. With written consent, we may use and disclose your child’s information with other professionals working with your child. If a parent/legal guardian would like Ready Set GO Therapy, Inc. to consult with other caregivers/professionals/persons, he or she shall sign and submit a Release of Information form for that function. 

Communication:   We send written reports via our secure email system.  Day to day communication via email is not secure. If you prefer to communicate via phone, please let our team know.

Healthcare Operations:   We may use your child’s information for appointment reminders (i.e. texts, voice mail, email, reminder cards).  We may use and disclose your child’s health information to obtain payment for services we provide.  Ready Set GO Therapy, Inc. is a teaching facility.  Your child’s information may be used for the education of occupational and speech therapy students and members of the community.  Students, volunteers, and supplementary staff will sign a confidentiality agreement to adhere to the privacy policies and practices as outlined in this document.  The quality of a child’s therapy session is of primary importance.  Students and volunteers will observe or participate only if this can be done without interfering with a child’s session.  For educational purposes your child’s information may be used without consent, only with name and identifying information excluded.  Occasionally persons within the community (for example, new parents or related services) may request to visit the facility.   Such visits will be conducted with consideration that your child’s session is the primary priority. 
READY SET GO THERAPY, INC. uses photography and video at times during treatment sessions.  Images and recordings may be shared with parent/guardian or with clients as part of the therapeutic process.  You may opt out of the use of photography or video in your child’s sessions by signing an opt-out form. 
 
Your Authorization:   You may give us written authorization (Release of Information) to use your child’s information or disclose it to anyone for any purpose.  If an authorization is provided to us for any individual or entity you may revoke the authorization in writing at any time.  
 
Marketing:   Ready Set GO Therapy, Inc. uses photography and video of clients for promotional and educational purposes.  You may opt out of the use of your child’s videos or photos for such purposes by signing an opt-out form. 
 
Required by Law:   We may be required to provide information to law officials under certain circumstances.  We are mandatory reporters. We may be obligated to use or disclose your child’s information if we believe that your child is a possible victim of abuse, neglect, domestic violence, or the possible victim of other crimes.     

We reserve the right to change our privacy practices at any time.  If we change the privacy practices, we will issue a revised notice of privacy practices.  If you wish to obtain an additional current copy of our privacy practices, you may obtain it at any time by contacting Jamie Close or Leigh Burkey at Ready Set GO Therapy, Inc.  This Notice takes effect September 25, 2020 and will remain in effect until replaced.

 Rates for Services: 
 
*A non-refundable down payment of $190 is required to reserve your first session. 
 
OCCUPATIONAL THERAPY (OT): 
 
For New OT Clients 
 
Comprehensive Evaluation Package: $760 for a 2-hour evaluation including standardized testing (as appropriate), clinical observations, and parent interview.  This evaluation is intended to determine whether occupational therapy is appropriate for your child, as well as to assess foundational skills and deficits, and to provide a more comprehensive understanding of how to best address your child’s needs.  The evaluation package includes time to score assessment tools, interpret results and develop a comprehensive written report including the findings and recommendations.  Additional testing, when necessary and/or requested, will be completed at a rate of $190 per hour.  The remaining balance is due upon completion of the evaluation. A parent conference will be required following completion of the evaluation.  
 
        Alternative Evaluation Options: 
 
        Outside Evaluation:  A current evaluation is required for ongoing therapy.  An occupational therapy evaluation completed at another facility within the past one year is acceptable.  If this option is chosen, first therapy session will be $380, which includes review of previous reports and a parent conference to establish and discuss the goals of therapy and the intervention plan. 
 
        For Children Under 2 years-old:  $380 for 1-hour for evaluation and written report.  Evaluation will include standardized testing (as appropriate), clinical observations, and parent report.  This evaluation is intended to determine whether occupational therapy is appropriate for your child, as well as to assess foundational skills and deficits, and to provide a more comprehensive understanding of how to best address your child’s needs. A parent conference will be required following completion of the evaluation.   
 
        Telehealth Evaluation Package: $760. This option is available only when an in-person evaluation is not feasible. This package includes 2 one-hour telehealth sessions which includes clinical observations via activities guided by the therapist and executed by the parent/caregiver and child, as well as parent interview and questionnaires. A written report will be provided, including the findings, accommodations, and a home program. A parent conference will be required following completion of the evaluation.  
 
Full-Service Evaluation Package with School Consultation: $1140, plus travel fee, inclusive of a comprehensive evaluation plus an hour of combined classroom observation and teacher consultation, and written recommendations or materials to support your child at school. A parent conference will be required following the completion of the evaluation.  
 
Screening:  $380 for a 55-minute session which includes screening items, structured observations, 1 page summary, and a 60 minute parent conference. The findings will be used to determine whether further evaluation is needed. Other recommendations may include accommodation/support strategies, home program development, parent education, or an outside referral.
 
For Existing OT Clients 
These services are available after completing an occupational therapy evaluation: 
 
Individual Treatment Sessions:  $190 per hour.  Treatment sessions are inclusive of a 55-minute session, plus 5 minutes for set-up/clean-up and documentation.  Treatment sessions are typically completed on-site at our clinic. Telehealth sessions are also used to enhance support at home and as an alternative option when on-site sessions are not feasible. 

If you are not staying at the clinic during your child’s session, please remember to return 10 minutes prior to the end of the session to allow the therapist to have about 5 minutes to check in with you and 5 minutes for set-up/clean-up and documentation of the session.

Note: Consultation with Parents and other Professionals is considered to be a critical component of therapy and leads to faster progress.  Parent conferences are recommended and will be scheduled at 3 months to revisit recommendations and address specific problem areas.    
 
Phone/Email/Telehealth Conferences or Consultations:  In order to best serve your child, we intend to keep open communication with families, and to collaborate with other caretakers and professionals involved in your child’s life.  There will be no extra charge for a phone or email consultation lasting up to 15 minutes.  $190/hour will be charged for phone conferences or emails lasting more than 15 minutes and will be pro-rated based on length of time in 15-minute increments. 
 
Travel Fee:  $50 + tolls incurred for up to 30 minutes of travel.  Additional travel time pro-rated at $90/hour. 
 
Home or Community Consultations:  Home or community-based consultations will be provided at $190/hour plus travel fee. Therapist can assess the home or community environment and offer suggestions for equipment or other accomodations to best support your child.

School Consultations: $380 plus travel fee.  Includes an hour of combined classroom observation and teacher consultation, and written recommendations, meeting, or materials.  Follow up conversations with school staff are recommended and will be charged at a rate of $190/hour pro-rated based on length of time. 
 
Progress Reports:  Progress reports and goal updates are completed every 6 months and will be charged at a rate of $190/hour, pro-rated on length of time to complete (typically 60 minutes).  Please let us know if your insurance plan has specific requirements in order to receive coverage.  If you prefer to receive the progress report in place of your child’s regularly-scheduled session, please let Ready Set GO Therapy know in advance. 
 
Updated Individualized Home Programs:  Updated individualized home programs will be developed, upon request, at a rate of $190/hour. 
 

 

FEEDING THERAPY:

For New Feeding Therapy Clients

Feeding Screening: $585 for a 90-minute session which includes screening items, parent questionnaire/interview, and a summary checklist. The therapist will spend an additional 90 minutes reviewing the feeding questionnaires and intake forms, compiling the findings from the screening to complete the screening checklist, establishing goals, developing a structured treatment plan, and preparing and sending support documents or information to the family.
A parent conference will be required following completion of the screening so that you have a good understanding of what may be impacting your child’s feeding as well as to support you in learning the first steps to help your child as they begin the feeding therapy process.

For Existing Feeding Therapy Clients
These services are available after completing a Feeding Screening:

Individual Treatment Sessions:
$195 for a 45-minute treatment session. The therapist will spend an additional 15 minutes each session planning for the next session and will communicate with families about what foods to bring to the next session as well as what to do at home to ensure carryover.
Treatment sessions are typically completed on-site at our clinic. Your therapist will communicate with you about what foods to bring to each session. Telehealth sessions may be used to enhance support at home and as an alternative option when on-site sessions are not feasible.

Parent Conferences:
Hourly rate of $195. Most parent conferences are 60 minutes, but conferences will be pro-rated in 15-minute increments based on the length of time. Consultation with parents about the feeding process is one of the most critical components of feeding therapy. Parent conferences 1 x a month are recommended to help ensure you gain confidence in knowing how to manage your child’s emotions and behaviors around feeding. Your therapist will work with you to make sure that you are providing the right type of environment and foods to support your child’s ability to move forward towards less stressful snack and mealtimes.

Phone/Email/Telehealth Conferences or Consultations: In order to best serve your child, we intend to keep open communication with families, and to collaborate with other caretakers and professionals involved in your child’s life. There will be no extra charge for a phone or email consultation lasting up to 15 minutes. $195/hour will be charged for phone conferences or emails lasting more than 15 minutes and will be pro-rated based on length of time in 15-minute increments.

Progress Reports: Progress reports and goal updates are completed every 6 months and will be charged at a rate of $195/hour, pro-rated on length of time to complete (typically 60 minutes). Please let us know if your insurance plan has specific requirements in order to receive coverage. If you prefer to receive the progress report in place of your child’s regularly scheduled session, please let Ready Set GO Therapy know in advance.

 

 

SPEECH THERAPY: 

For New Speech Therapy Clients

Low Complexity Speech Evaluation Package: $490 for a 1.5-hour evaluation to
assess one area of concern such as articulation, fluency, or voice quality. The low
complexity package includes standardized testing (as appropriate) and parent input. The evaluation includes a written report including the findings and
recommendations. Additional testing, when necessary and/or requested, will be
completed at a rate of $195 per hour. A parent conference will be required following
completion of the evaluation.

High Complexity Speech Evaluation Package: $780 for a 2-hour evaluation to
assess speech and language skills or to assess more than one area of concern such as articulation, fluency, or voice quality. The high complexity package includes
standardized testing (as appropriate), observations, and parent input. The
evaluation includes a written report including the findings and
recommendations. Additional testing, when necessary and/or requested, will be
completed at a rate of $195 per hour. A parent conference will be required following
completion of the evaluation. 

Alternative Evaluation Options for Speech Therapy:

Outside Evaluation: A current evaluation is required for ongoing therapy. A speech therapy evaluation completed at another facility within the past one year is acceptable. If this option is chosen, first therapy session will be $390, which includes review of previous reports and a parent conference to establish and discuss the goals of therapy and the intervention plan.

Screening: $295 for a 55-minute session which includes screening items, and a
summary checklist. The findings will be used to determine whether further evaluation is needed. Other recommendations may include accommodation/support strategies, home program development, parent education, or an outside referral.

For Existing Speech Therapy Clients
These services are available after completing a speech therapy evaluation:
 
Individual Treatment Sessions:   
  45 minutes*   $170 
  60 minutes*   $195 

Treatment sessions are typically completed on-site at our clinic. Telehealth sessions are also used to enhance support at home and as an alternative option when on-site sessions are not feasible. 

If you are not staying at the clinic during your child’s session, please remember to return 10 minutes prior to the end of the session to allow the therapist to have about 5 minutes to check in with you and 5 minutes for set-up/clean-up and documentation of the session.

Note: Consultation with Parents and other Professionals is considered to be a critical component of therapy and leads to faster progress.  Parent conferences are recommended and will be scheduled at 3 months to revisit recommendations and address specific problem areas.    
 
Phone/Email/Telehealth Conferences or Consultations:  In order to best serve your child, we intend to keep open communication with families, and to collaborate with other caretakers and professionals involved in your child’s life.  There will be no extra charge for a phone or email consultation lasting up to 15 minutes. $195/hour will be charged for phone conferences or emails lasting more than 15 minutes and will be pro-rated based on length of time in 15-minute increments. 
 
Travel Fee:  $50 + tolls incurred for up to 30 minutes of travel.  Additional travel time pro-rated at $90/hour. 
 
Home or Community Consultations:  Home or community-based consultations will be provided at $195/hour plus travel fee.  Therapist can assess the home or community environment and offer suggestions for equipment or other accommodations to best support your child.
 
Progress Reports:  Progress reports and goal updates are completed every 6 months and will be charged at a rate of $195/hour, pro-rated on length of time to complete (typically 60 minutes).  Please let us know if your insurance plan has specific requirements in order to receive coverage.  If you prefer to receive the progress report in place of your child’s regularly-scheduled session, please let Ready Set GO Therapy know in advance. 
 
Updated Individualized Home Programs:  Updated individualized home programs will be developed, upon request, at a rate of $195/hour.

 

FRIENDSHIP EXPLORATIONS OUTDOOR GROUPS AND SESSIONS:

Ready Set GO Therapy offers outdoor summer camps, school break camps, and after school groups services for children ages 4 through 13 years, grouped by age and group fit. Operated by an expert licensed OT or Speech Therapist plus an assistant, our groups include up to 6 children and offer a 3:1 ratio. Through a combination of teaching and unstructured supported play, we address a wide variety of friendship and development skills such as sensory processing, emotional regulation, following directions, sequencing, play skills, balance and strength, problem solving, confidence building, and independence. Includes review of therapeutic needs and goals, customized group plan based on the individual needs of each child, email report with explanation of activities and therapeutic benefits, and a photo log.
Individual sessions and dyads or smaller group sessions may also be available.

*Rates vary based on session length and size. Refer to our website for current rates, schedule, and additional details. Contact us to set up an intake call to determine if Friendship Explorations is right for your child.

 

SCHOOL BREAK HANGOUTS AND TEEN/TWEEN HANGOUTS:

School Break Hangouts and Teen/Tween Hangouts may be available. Hangouts provide an opportunity for children to participate in themed crafts, games, snacks, and other activities alongside other children in a sensory safe environment under the supervision of a skilled OT or Speech therapist.
Group size is 3-8. School Break Hangouts are offered for children ages 4 and up. Teen/Tween hangouts are offered once monthly on Fridays for ages 11-14.

*Contact us for rates, schedule, and registration details.

 

DYADS AND GROUPS:

Dyads and group services may be available.  These provide an opportunity for children to safely practice social skills in a safe, small group environment.  Given the importance of the group dynamics, groups are offered when appropriate peers can be paired.  Two or three children may work together and an OT or Speech Therapist will lead sessions based on the profile and needs of the group.

Please speak with your child's therapist if you feel your child may benefit from a small group.

 

CANCELLATIONS AND OTHER FEES: 
Consistency is critical to your child’s progress. Our therapists are committed to meeting your family’s goals.  We do understand that conflicts or illness occasionally occur.  If your child or another household member develops a contagious illness and has potentially exposed other children at our facility to the illness (for example conjunctivitis, chickenpox, head lice, or impetigo), Ready Set GO Therapy should be notified at once.   We expect cancellations to be rescheduled.  When a therapist must cancel, we will offer make-up sessions.  The following cancellation policies apply:  

• Telehealth sessions are a viable alternative when in-person sessions are not feasible and can bring added value. Please contact Ready Set GO Therapy if you would like to schedule a telehealth session in place of an in-person session. 
• Cancellations with less than 24-hours notice will be charged at a non-refundable full session rate. There are no exceptions to this policy, as it is necessary to cover the time that your therapist has reserved specifically for your child. During this time, your Therapist will provide a support service to you or your child's team through email, phone, or by creating materials that will support your child. Such services are a critical part of the therapeutic process and play a valuable role in supporting your child’s progress.
• All other cancellations will be charged at $40 unless rescheduled within 2 weeks.  Cancellations are discouraged and make-ups are dependent on therapists’ availability. Make-up sessions require flexibility, as they may not match family’s ideal availability or may be scheduled with an alternative skilled and qualified therapist.  Ready Set GO Therapy therapists are trained and prepared to work with each other’s clients in the case of therapist cancellations and make-up sessions. We have found that sharing clients brings added benefits such as new perspective and collaboration among therapists, as well as increasing a child's flexibility. 
• If there are 3 or more cancellations per trimester, you will be asked to change to our “Flexible Schedule”* model.  This allows for you to book treatment sessions based on your own schedule and the availability of therapists. 
• Cancellations must be made by phone or confirmed in writing.  Verbal cancellations made during a session are not documented and must be followed up via phone or email to 415-339-8800 or info@readysetgotherapy.com  
   

*Flexible Schedule:  When consistent weekly sessions are not feasible, sessions can be booked on a session by session basis, based on your own schedule and therapist availability. 
 
Other fees 
There is a $30.00 fee for returned checks, in addition to any fees charged to us by our financial institution.  A late fee of $20 along with a 4% interest charge may be applicable if payment is not received within 30 days of billing date. 

 

FAQ:
How should I prepare for my first session?

• Complete the Welcome Packet forms and Questionnaires and return them to the RSGT office
• Provide RSGT with any outside evaluations or reports
• Be sure to confirm the first session and pay the deposit
• Relax, and know that you are good hands! We look forward to working with you!

How should I explain to my child why we are going to Ready Set GO Therapy?

First, rest assured that you are probably are more concerned about this than your child. Children have open minds. While therapy has a history of being stigmatized, our society is beginning to understand that everyone learns in different ways and has different areas of strengths and weaknesses, and this is okay! In fact we are learning to celebrate each other's differences as a means of enrichment.  The way that you explain “why” is different based on each individual situation. Here are some tips:

• A sample way to present this is: “The teachers at RSGT are very good at helping kids learn new ways to (write/get ready for Kindergarten/calm their bodies/etc., practice their speech), and they help a lot of kids to do this.”
• Focus on the positive. Avoid telling a child that they need therapy because they are “bad” at something or “have a problem with (X,Y,Z)”. We do not want to a child to feel that they are failing. Instead focus on how this class teaches new things, as above.
• Rest assured that once your child meets their therapist, it will be clear that they are understood and that they feel safe. Most kids leave eager to return!

Holidays
Ready Set GO Therapy, Inc. will be closed for New Year’s Day, 4th of July, Thanksgiving, day after Thanksgiving, and Christmas Day. If you plan to be out of town on one of the following holidays, you will not be charged for cancellations, as long as advanced notice is given.

Martin Luther King Jr Day
President’s Day
Memorial Day
Juneteenth
4th of July
Labor Day
Christmas Eve
New Year’s Eve

If you would like a session on a holiday, please let us know as some therapists may be able to accommodate this. Ready Set GO Therapy does not follow the school holiday schedule. Please contact us if you are unsure if we are open.

 

Payment
Payment is due on a monthly basis. If your child’s last name starts with A-L, you will be billed in the middle of each month. If your child’s last name starts with M-Z, you will be billed at the end of each month. Payment options include credit (we accept Master Card, Visa, and American Express), debit, or check. Cash will also be accepted if exact change is given, as we do not keep cash readily available as change. Ready Set GO Therapy, Inc. does not bill insurance. However, we will provide information needed to assist in receiving reimbursement, based on your individual policies. Please inform Ready Set GO Therapy, Inc. if any additional information is requested by your individual insurance policy. Charges are non-negotiable as agreed upon in service agreement. If payment is not made within one month of billing date, your child will no longer receive services until the account is up to date and charges may apply.

*Note: Rates are subject to change. A minimum of 2 weeks advanced written notice will be provided.

Additional Considerations:

At your child’s treatment session
Pick-up is required 10 minutes prior to the end of your child’s scheduled session to provide an opportunity for discussion and home program recommendations. If a non-parent caregiver is responsible for pick-up, parents may request a session in which the therapist uses the last 5 minutes to send a recap of the session. Therapists have very tight schedules and do not have the flexibility to have extended conversations without prior notice during a regular therapy day. Communication is important; if there are questions or comments that need to be discussed, the parent may request to have a shortened session with a private conference or set up an additional parent conference appointment.
To ensure everyone’s safety, please do not allow children onto the mats or other equipment without the direct supervision of a therapist during your child’s scheduled therapy session.

In addition, for the safety of your child, Ready Set GO Therapy, Inc. asks that you are prompt in picking up your child at the end of his or her session. Ready Set GO Therapy, Inc. is not responsible for supervising your child before the session has started, or after the session has ended. You will be charged at the regular therapy rate for late pick-ups.  If anyone other than the parent will be picking up your child, please notify Ready Set GO Therapy. We cannot accommodate children who are dropped off early for therapy sessions. Please make sure your child is supervised at all times prior to and after the therapy appointment.

During Telehealth treatment sessions, a parent or caregiver must be present at home, and must confirm their physical address at the beginning of each session. At least one emergency phone contact must be provided, in addition to primary caregiver contact information. In most cases, the parent must be present throughout the session to provide physical assistance and support to the child and to gather necessary equipment.

Attire
Clothing that is well fitted to the child’s body, casual (active wear), and seasonable will be appropriate. Your child may be invited to participate in messy play. Shoes are not permitted on areas with mats.

Pets
Service animals are permitted. Other pets are not allowed in the building due to potential sensitivity of children in the facility.

Emergency and Disaster Preparedness
In the case of evacuation due to a natural disaster or emergency at our Sausalito clinic, our established nearby meeting place is in front of the Sausalito US Post Office (150 Harbor Drive, Sausalito, CA 94965 ). If this location is not safe, our established meeting place is in front of Mollie Stones (100 Harbor Dr, Sausalito, CA 94965).

In the case of evacuation due to a natural disaster or emergency at our Novato clinic, our established nearby meeting place is in the Creekside Professional Center parking lot. This is the parking lot next to our clinic. We will gather at a safe location in the lot, likely the furthest corner from our clinic. If this location is not safe, our established meeting place is across the street in front of the Marin Humane Society (171 Bel Marin Keys Blvd, Novato, CA 94949).

In the case of catastrophic emergency, we may be forced to cancel sessions. We will attempt to contact you as quickly as we are able to safely do so.

Discontinuing Services
The decision to discontinue services should be a collaborative decision between the family and the therapist, and typically occurs once a child’s needs are able to be met through an established home program and/or other services within the community. If you decide to discontinue services or are unable to continue sessions at your child’s current time, a 2-week notice to discontinue is required to avoid a cancellation charge.

Right to Refuse or Discontinue Services
Interpretation, recommendations, and treatment plans are based, in part, on the history and information that you provide Ready Set GO Therapy, Inc. If information about your child's medical/educational history, interventions, and needs are withheld, misrepresented, altered, or omitted, Ready Set GO Therapy, Inc. reserves the right to terminate the services. Services may be refused or discontinued due to non-payment of services, aggressive behavior, lack of progress, lack of cooperation, or a poor match between the needs of the family and skills of the therapist.

Therapists
We hand select our therapists through an intensive application and hiring process and we have complete confidence that each therapist will uphold our high standard of practice.

Ready Set GO Therapy, Inc. takes pride in providing the highest quality service to your family and your child. If you have any questions, concerns, or feedback, please contact us.

Occupational Therapy Service Rates:

Evaluation:	$760
Evaluation w/School Consultation:	$1140 +travel fee
Telehealth Evaluation:	$760
Screening:	$380
1st session, outside evaluation:	$380
Treatment session:	$190
(includes 55 min. session, planning & documentation)
Phone/Email consultation:	$190/hour
(pro-rated based on length of time in 15-minute increments. No charge if less than 15 minutes)
Off-site consultation:	$190/hour +travel fee
Travel fee:	$50 +tolls
(for up to 30 minutes of travel. Additional travel time pro-rated at $80/hour)
School consultation:	$380 +travel fee
Progress reports:	$190/hour
Written home program:	$190/hour

  

Speech Therapy Service Rates:

Evaluation- one area (or low complexity):	$490
Evaluation- multiple areas (or high complexity)	$780
Screening:	$295
1st session, outside evaluation:	$390
Treatment Session:	$170/45 minutes $195/60 minutes
Phone/Email consultation:	$195/hour
(pro-rated based on length of time in 15-minute increments. No charge if less than 15 minutes)
Off-site consultation:	$195/hour + travel fee
Travel fee:	$50 +tolls
(for up to 30 minutes of travel. Additional travel time pro-rated at $80/hour)
Progress reports:	$195/hour
Written home program:	$195/hour

 

Other fees:

Cancellations (ALL cancellations must be made by phone or in writing)

• Cancellations with less than 24 hours notice will be charged at the full session rate
• All other cancellations will be charged at $40 unless rescheduled within 2 weeks
• If there are 3 or more cancellations per trimester, you will be asked to change to our “Flexible Schedule” model.  This allows for you to book treatment sessions based on your own schedule and the availability of therapists

Late pick-ups:	Session rate pro-rated on length of time
Returned Check:	$30 + any bank fees
Late Payments:	$20 & 4% interest on outstanding balance of 30 days or more from billing date

 

I confirm that I have received and reviewed the Parent Policies and Procedures and agree to adhere to the terms stated.  

Between:	READY SET GO THERAPY, INC.
	180 Harbor Drive, Suite 112
	Sausalito, CA 94965
	415-339-8800
	info@readysetgotherapy.com
And:
(Please list all applicable)

This consent is valid and in effect for two years, unless written request to renew or withdraw this form is provided.

Authorized by: