Dr. Sharon P. Austin, Licensed Psychologist
Seeing the other, and being seen, as if for the first time

Appointments and Fees

  • Initial 20-Minute phone or in-person consultation at no charge
  • 50-Minute Session - $130
  • Cash and checks accepted as forms of payment.
    Payment is expected at time of service.

Insurance

Dr. Austin has extremely limited contracts with insurance companies. It is your responsibility prior to the first session to check if Dr. Austin is a contracted provider and to receive your authorization for services. She will provide a monthly statement for you to submit to your insurance or HSA/Flex Savings plan.

Payment Contract for Services - to be printed off and signed.  Part One Fees for Professional Services Part Two Release of Information Authorization to Third Party  Part Three Consent for Treatment with Sharon P. Austin, Psy.D.


Disclosure Statment to be printed off and signed by the client.

What follows is information I would like you to have about me as your therapist. Please read and sign your name on the reverse side. If you have any questions, please ask me.


THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

PLEASE REVIEW IT CAREFULLY.

"My commitment to your privacy ... "


 

315 Canyon Avenue | Suite A | Fort Collins | Colorado | 80521 | MAP | 970.493.4093

Graphics abstract taken from stained glass: Glass by Fox 970.495.0462
© Copyright 2015, Dr. Sharon P. Austin, all rights reserved.

 

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