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INITIAL CONSULTATION
Please download, print out, and complete these registration forms prior to coming in for your initial consultation.
We will need to receive these before we can confirm your initial appointment. If you are paying by check, please include a check made out to "Daniel Merlis": $210 for individual consultation or $265 for couple/family consultation along with the completed forms. War-zone veterans, firefighters,
trauma nurses and EMTs, police and federal security agents, please
include a check for $150
with the
registration forms. We ask for credit card information. You may
elect to use the credit card as the primary payment method, or as a backup when
a check is not available or for other reasons. If you are currently being
treated by a psychiatrist and/or psychotherapist, please complete one one or
more of the release forms so that we can contact your treating clinician(s) in
the future if appropriate. We will discuss this with you prior to making
any contact and would do so only after our initital consultation.
If you are
willing to participate in the Psychotherapy Training
Project, you are eligible for a fee of $160 for individual psychotherapy sessions.
Please
complete an
audio-video
consent form and include this with your registration forms.
If
you are unable to afford this reduced fee schedule, I will consider on a
case by case basis an additional fee reduction. Please complete this
application
form and mail it to me with the other registration and audio-video consent
forms above. I will consider your request and respond within several days. I
have a limited number of openings and you might have to consider joining a
waiting list until an opening becomes available.
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