How To Book An Appointment – Wall Street Psychologists PLLC

WE ARE NOT TAKING NEW PATIENTS.

First Name

Last Name

Date of Birth

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Telephone

What is your insurance plan:

Member ID from your insurance card

Is this plan through your job:

If not through your job, then through whom are you insured?

Is this appointment request for individual therapy for yourself, or are you seeking a joint session with a partner?

Is this appointment for someone older than 18?

Yes

Are there any days or times you are unable to schedule regular weekly appointments?

OUR POLICY ABOUT CANCELLED APPOINTMENTS

When you decide to enter therapy with one of us, your therapist is reserving that appointment time for you every week, until you decide to discontinue. We do allow two canceled appointments within each quarter of the year. If for any reason you miss more than two appointments in a quarter, or if you miss any appointment without notifying us prior to the appointment time, you will be responsible for paying for those sessions at the full amount of your insurance network’s contracted rate with us. Insurance plans will not pay any part of the charge for missed sessions.

WE ARE NOT TAKING NEW PATIENTS.

OUR POLICY ABOUT CANCELLED APPOINTMENTS

Wall Street Psychologists PLLC © 2016