Jennifer W.Walken Ed.D - Intake Forms

Prior to your initial visit, please take the time to print and fill in an:

Be sure to bring these forms with you to your first visit. It would also save time if you read through the Privacy Practices before your visit.

We strive to make psychotherapy services accessible and affordable by participating in a variety of health insurance programs and will gladly discuss fees prior to making an initial appointment. We do accept and will file most insurance plans. However, we also realize that some people may prefer to bypass their insurance plans because of lack of choice of therapist, treatment, or confidentiality concerns.

Please know we do our best to handle insurance needs in a timely fashion; however, insurance policies have become more and more complex leading to more time-consuming errors; therefore, please be aware of the following:

It is your responsibility to be informed, stay informed, and communicate with us about your insurance benefits. We ask that you call your insurance company before your visit and check your mental health benefits so we will both understand them to minimize unwelcome surprises.
Your benefits are not guaranteed until claims are filed and your insurance pays on those claims.
We are only as accurate as the information your insurance company gives us and we are required to charge you what they tell us to charge you. If you feel there is an error, then you must address the issue with your insurance company and pay your bill on time. We are not financially responsible if there is a disagreement between what you thought your insurance would pay and what they ended up paying.
You are also responsible for being aware of how many sessions your insurance company allows per year and to keep track of how many sessions you are using. Do not forget to include any other mental health providers such as psychiatrists in the total number of sessions allowed per year.
Please let us know if your insurance benefits have changed for any reason. We recommend that you call your insurance at least once every year to keep up with any changes.

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