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Forms: 
​
If you are a new client, please fill out the following forms and email them back to me before our first session.  Alternatively, please print them out and bring with you to our first meeting. Please note that I do not need the HIPPA form back.  ​​
Intake Form
File Size: 94 kb
File Type: pdf
Download File

HIPPA Form
File Size: 119 kb
File Type: pdf
Download File


Office Policies
File Size: 132 kb
File Type: pdf
Download File

Electronic Payment
File Size: 29 kb
File Type: pdf
Download File


eMail Text Consent
File Size: 74 kb
File Type: pdf
Download File

Permission to Record Therapy
File Size: 78 kb
File Type: pdf
Download File


Fees:
​Cost per session: $200.00
Takes insurance:  No
Takes credit card:  Yes
Offers discount:  Yes, I donate 15% of my income to helping those who could not otherwise afford my fee for psychotherapy.  Thus, there are a limited number of spaces for folks to whom I can offer lower fees. My apologies if my discounted slots are full when you inquire.  However, if this is the case, I would be more than happy to help out with a referral. 
Copyright Dr. Anne Cooper 2017
  • Home
  • About Therapy
  • About Dr. Cooper
  • About My Practice
  • Forms & Fees
  • Contact