Adrienne Panter, Psy.d, LPC
 
 
 
 
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Forms & Policies


FORMS

Please review and complete the following Patient Disclosure and New Patient Information forms at the bottom of the page prior to our first session.

If you wish to grant permission for Dr. Panter to be able to communicate with any of your other healthcare providers, family members, or other specified parties on your behalf, please complete the Authorized Release Form (optional).


New Patient Information

Authorized Release Form

Patient Disclosure Form


POLICIES

Sessions

A standard therapy session is 50 minutes long. Longer or shorter sessions are also possible based upon client need. Initial visits focus on evaluating presenting issues, concerns, needs and goals for therapy. We will work together to establish specific, individualized treatment objectives tailored to your individual needs. Throughout the course of working together, we will continue to monitor and discuss your progress in reaching your goals, and modify the focus of therapy according to your needs.

Fees & Insurance

Please review my Consent Form for information on policies and fees and contact me with any questions. With regards to health insurance, some policies will provide some coverage for "out of network" mental health treatment. This typically occurs as reimbursement for fees you have already paid for clinical services. I can provide you with a monthly statement of services rendered, if desired, which you can submit to your insurance carrier. Please be aware that it is your responsibility to provide full payment before submitting this information to your insurance company.

Cancellation Policy

If you need to reschedule or cancel an appointment, please notify me by at least the day before so that I can offer that time to someone else. If there is a compelling reason, such as an emergency, cancellations on the same day of a scheduled appointment will not be charged. Same day cancellations, or no shows without a legitimate reason (such as illness/emergency) shall be forgiven (not charged), one time, but will be charged $50 the 2nd time, and $75 per occurrence thereafter. If you need to cancel or change an appointment, you can notify me via e-mail, text message, or by leaving a voicemail on my phone