Mandarin Cove Counseling : Jacksonville

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Fees and Forms

Forms

It is my goal to make your experience at Mandarin Cove Counseling seamless. As such, I want to expedite the necessary paperwork. Prior to arriving at your first session, please take a moment to fill out the following forms:

  1. General Client Information
  2. Counseling Information
  3. Informed Consent Form
  4. Notice of Privacy
  5. Permission for Treatment
  6. Agreement Concerning Minors
    (only for individuals under 18)
  7. Relationship Happiness Quiz
    (couples only)
  8. Relationship Questionaire
    (couples only)

Pay for initial assessment Now



Pay for a 50-minute Session Now



Counseling Fees

Individual, Couples, Family or Online Counseling
Initial Assessment: $150.00 for 50 minute session
Subsequent sessions: $120.00 per 50-minute session

Group Counseling
Price dependent on session. Please call for details on group counseling pricing and available sessions.

Accepted Insurance

Mandarin Cove Counseling is an “out of network” provider, so I do not accept your insurance directly. However I can provide you with a “superbill” which can be submitted to your insurance carrier for reimbursements. A superbill is a weekly or monthly summary of your payments that insurance companies use to process reimbursements. You should contact your insurance company and ask them what their reimbursement terms are for therapy sessions. Please be aware that if you choose to submit a superbill to your insurance company, your private medical information will be released. This may impact your future insurance coverage, rates, and reimbursement.

Cancellations

We understand that sometimes conflicts arise. If you need to cancel or reschedule your appointment, please contact us within 24 hours to avoid being billed for your full session.

Accepted Payment Options

  • Cash
  • Check
  • Credit Card (online only)