Fees & Forms

 

Individual Session Fees

 
Intake or Follow-up Appointment: $180.00/session hour

Although I am not contracted in-network with any insurance company, I can provide a medical receipt (aka: Superbill) for you to submit to your insurance company directly. They usually reimburse your out-of-pocket expense, at least partially. You may want to contact your insurance company to get the specific details of your Out of Network benefits.

 

Cancellation Policy

If you do not show up for your scheduled therapy appointment, and you have not notified me at least 24 hours in advance, you will be required to pay the full cost of the session. Emergencies and illnesses do not apply.

Pay Here

Spiritual Transformation & Intensive Trauma Healing Program Fees

 A 50% deposit is collected at the time of scheduling your session and only after an Intake & Assessment have been completed (1-hr session completed either in person, over the phone, or virtually online).  Please click on one of the boxes below to pay your deposit.

Fees:

  • $1650 for the Spiritual Transformation Program Package: 3 Half Day Sessions, up to 9 hours (deposit $825) 
  • $595 for a Half Day Intensive, up to 3 hours (deposit: $297.50).
  • $1,195 for a Full Day Intensive, up to 6 hours (deposit $597.50).  

Cancellation Policy

Because so much time is set aside for your Intensive Healing Program, the cancellation policy is different from an individual (1-hr) appointment. If you cancel your appointment with at least 5 days notice, your deposit will be refunded or applied toward a future, re-scheduled appointment within 30 days of the originally scheduled appointment.

If you cancel with less than 5 days notice, for any reason, your deposit will not be refunded, but can still be applied toward a future, re-scheduled appointment within 30 days of the originally scheduled appointment. 

There is a $50.00 discount if paying with cash.

Please click on one of the boxes below to pay your deposit.
Half-Day Intensive Trauma Healing Session - upto 3 hours
Full-Day Intensive Trauma Healing Session - upto 6 hours
Spiritual Transformation Program Package - 3 Half-Day Sessions

You can sign and fill out all forms online

 

INSTRUCTIONS: Please only complete these forms AFTER scheduling an intake appointment with Lisha Song.

 

Start with the Disclosure Statement below.
After you sign and date it you will get confirmation and the next form link.
Continue through the whole sequence of forms. There are a total of 7 forms, but the first 5 are signature only.
When you click submit, your form is emailed to Lisha Song.

You can now save your progress as you go and come back to the form.
If you need to start again come back to this page and click on the form.

START HERE

1. Disclosure Form

2. Telehealth Disclosure

3. Covid Release

4. Intensive Healing Disclosure

5. Receipt of Hippa

6. New Client Information

7. Initial Client Intake

 

Questions?

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