Prior to your first appointment, please review, print, and complete the registration forms below. Bring these completed forms with you so that we can devote more time to getting to know each other. We look forward to seeing you soon.

Patient Forms

Print and complete these forms as instructed by the Beech Tree staff.

Adult Registration Packet

Child Registration Packet

Mutual Disclosure form

Services Policies

A crucial part of the therapeutic process and our therapeutic relationship is open, honest, and clear communication. The purpose of the Service Policies is to maintain a level of clarity in understanding the “nuts and bolts” of the therapeutic relationship. In doing so, we can avoid miscommunication around policy/procedure issues that can interfere with our work. We are happy to address any questions you may have at any time. Please initial each section as indicated acknowledging that you have read, understand, and agree to each policy.

Scheduling
To schedule, confirm, or change an appointment please call our office at 317-780-5750. Our staff will be happy to help.

Psychotherapy Session Duration
The typical psychotherapy session lasts between 45 and 55 minutes. Please refer to our Services Policy under Patient Forms for more specific information about session duration.

Cancellation Policy
If you need to cancel your appointment, please provide us with notice 24 hours in advance. Fees will be automatically charged for appointments not canceled with 24-hour notice. A No Show feel will also be automatically charged if you do not arrive for your scheduled appointment. These fees must be paid at or before your next scheduled appointment. Please refer to the Services Policy under Patient Forms for more detailed information.

Payments
Many of our mental health professionals are preferred providers with Anthem Blue Cross Blue Shield health insurance. We also offer affordable self-pay rates. Please see our Services Policy under Patient Forms for more detailed information about our fees and payment polices. Our Standard Rates are listed below.

Standard Fees (Doctoral level clinician)

Initial Intake$225 (50–55 minutes)
Individual Therapy$150 (16–37 minutes); $175 (38–52 minutes); $200 (53–55 minutes); $250 (90 minutes)
Group Therapy$50 (55 minutes); $70 (75 minutes)
Family Therapy$175 (38–52 minutes); $200 (53–55 minutes); $250 (90 minutes)
Psychological Assessment$175/unit or hour
Psychotherapy No Show$100
Psychotherapy Late Cancel$50
Testing No Show or Late Cancel$200


Standard Fees
 (Masters level clinician)

Initial Intake$125 (50–55 minutes)
Individual Therapy$75 (16–37 minutes); $90 (38–52 minutes); $105 (53–55 minutes); $135 (90 minutes)
Group Therapy$30 (55 minutes); $50 (75 minutes)
Family Therapy$100 (38–52 minutes); $115 (53–55 minutes); $145 (90 minutes)
Psychotherapy No Show$100
Psychotherapy Late Cancel$50

*Standard fee for clinicians in training for all services, including No Show and Late Cancel charges, is $50.


Non-Covered Services

*Non-Covered Services include all services not typically covered by third-party payers (mental health/medical insurance).

Non-Covered Administrative Services$15 per 5 min increments (no charge for first 5 minutes)

These services most often include but are not limited to:

  • Consultation with medical, mental health, or academic professionals on your behalf by phone, e-mail, fax, or in person.
  • Review of medical records
  • Preparation of reports or letters for other providers/legal counsel, etc…
  • Completion of documents for disability claims, extended insurance reviews, worker’s compensation, etc…
  • Duplication of medical records (photocopying fees, notary fee, and postage fees may also apply)

Non-Covered Mental Health Services (services which are clinically recommended but that may not be covered by your insurance company)

  • Standard fees apply. See above. A quote will be provided and agreement for payment of services rendered will be required before services will be provided.

Service Limitations
Please be advised that we do not provide legal or forensically-informed therapeutic services. If you require services of this nature, we will provide you with referrals to appropriately qualified mental health professionals. We also will not voluntarily provide letters to attorneys or legal counsel regarding our work together. If you become involved in a legal suit, please inform us immediately so that we can develop an appropriate treatment plan and we can provide you with necessary referrals.

Office Hours
We typically have coverage of our phones by an administrative assistant Monday through Thursday 8am to 4pm and Friday 8am to 12noon. Our mental health professionals may keep different office hours. Please consult with your mental health professional regarding their in-office availability.

Please feel free to call at any time and leave a voice-message. We do check messages frequently and will return your call as soon as possible.

Crisis Information

In the event you find yourself in crisis please contact the crisis line or visit your nearest emergency room. The crisis line is available 24 hours a day, 7 days a week. If you are in crisis, please seek help immediately.

Local Crisis Line 317-251-7575

National Crisis Line 1-800-273-8255

Text HOME to 741741