Intake and Consent Forms
Below you will find a link to the intake form you'll need to complete before scheduling your first session. Please follow the instructions carefully and print or save a copy of the document before you submit it.
Below is a release of information form that you should fill out if you want us to communicate with other agencies,
Below is the informed consent form that outlines a wide ranges of issues you must review and agree to or decline before you begin therapy,
Below is a link to the $29 Gottman Relationship Checkup we are now using with relationship therapy.
Fees and Insurance
Most psychotherapy services in Kansas are covered by health insurance or count toward deductible...
Family Psychological Services directly bills most insurance plans. Other plans like Humana and United allow out-of-network benefits. Please contact your health insurance providers to find out the details of your coverage. Copay, deductible, coinsurance, and any other services not covered by your insurance must be paid at time of service or set up on a monthly payment plan, as described below. Due to restrictive Medicare billing policies and auditing procedures, we only serve Medicare patients who are within our scope of practice on an "opt-out" cash-only basis at our usual and customary rate.
Why you might want to opt out of using your health insurance for psychotherapy services...
Historically in Kansas, insurance carriers were regulated closely by a powerful insurance commissioner who took seriously consumer protection. As the political winds have shifted, consumers must take a closer look at their insurance benefits, particularly in the highly sensitive area of psychotherapy and psychoharmacology. Blue Cross and Blue Shield of Kansas, the largest insurance carrier in the state, regularly accesses private mental health records via it's sub-corporation New Directions in order to conduct utilization review and determine “medical necessity” for treatment. If you've signed up for BCBS KS, you've already agreed to release that information.
We strongly urge you to click below to learn more about insurance and the fee structure at FPS.