Lindsey Kremmel, PhD
Licensed Psychologist PSY22875
Appointments & Forms


Getting Started

If you would like to speak with me to learn more about my services, please visit my Contact Me page to learn how to do so. After I am contacted by you, we will arrange a 10-15 minute phone consultation to determine if my skills and services are a good fit with your needs. This initial phone consultation is free of charge. If we determine that my services are not a good fit for you, I will offer you referrals to other professionals in the community. If it appears that my services can be of help to you, we will set up an appointment to meet in person. 

Appointments

An appointment is a commitment to our work. I will consider our meetings very important and ask you to do the same. Your session time is reserved for you. If you do not give me at least 24 hours notice before canceling, or if you simply do not attend the appointment (“no show”), you will be charged the full fee for the missed appointment. 

Fees

Psychotherapy services: 

For a session of 45 minutes (a "clinical hour"), the fee is $130-$150. I do offer a limited amount of sliding-scale appointment slots for clients unable to pay the full amount. If this applies to you, please speak with me. 



Health Insurance Coverage: I am not a member of any health insurance plans or panels. However, many health insurance companies will reimburse clients for seeing an "out of network provider". I will supply you with an invoice for my services with the standard diagnostic and procedure codes for billing purposes, the times we met, my charges, and your payments. You can use this to apply for reimbursement. Please note that (due to a conflict of interest) I cannot see any client who has Medicare, Medicaid, or Medi-Cal insurance.

I currently accept check or cash. I can provide a receipt for cash payments. A $25.00 fee will be added to your balance for any check returned by the bank.

 

Forms

Prior to our first session, please print and read, the following forms.  Please bring them to our first meeting. We will discuss them and sign a signature page during our first meeting. If you do not have access to a computer/printer, please let me know and you can arrive at my office 30 minutes before our first meeting to read and complete the forms. 

For services involving CHILDREN/ADOLESCENTS/FAMILY:
Please PRINT and FILL OUT:
Child___Family_History_form.pdf
102.3 KB

Child_age_0-17_Parent_Report_Measure_of_Early_Development.pdf
294.1 KB

Child_age_6-17_Parent_Report_Measure.pdf
294.7 KB

Child_age_11-17_Self_Report_Measure.pdf
281.3 KB

Please READ:
Notice_of_Privacy_Practices.LK.7.21.12.pdf
114.3 KB

Intake_Packet_-_Information_for_Clients_8.5.16.pdf
146.9 KB



For services involving ADULTS only:
Please PRINT and FILL OUT:
Adult_History_Form..pdf
102.7 KB

Adult_Self_Report_Measure.pdf
287.0 KB

ACE_Questionnaire.pdf
1.8 MB


Please READ:
Notice_of_Privacy_Practices.LK.7.21.12.pdf
114.3 KB

Intake_Packet_-_Information_for_Clients_8.5.16.pdf
146.9 KB


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