Leah Koenig, MA, LMHC
Parent Coach ~ Family Therapist

Bellevue Family Counseling, LLC
1601 116th Ave NE, Ste. 102
Bellevue, WA  98004
425-417-5902

Print these forms and bring them to your first session.

How to Get Started

 

Forms

Please download, complete and sign the first three forms and bring them with you to the first appointment.  These are necessary for me to provide services.  If you have any questions, please feel free to call 425-417-5902 or bring your questions to our first session.

*If you are a new client, please email or call to confirm I have availabiity to see you or your child before booking an appointment.  

Forms for Leah   Forms for Jenna
Disclosure of policies agreement    Available when you meet Jenna
HIPAA notice of privacy & receipt    
New client questionnaire    
     
*Only if requested by Provider    
Parent Coaching Introductory Form    
Client release of information agreement    
Video release    
Court & Legals Fees - Posted for review      

 

Fees

Please note that I request payment upon completion of each session. Your insurance company may provide coverage for our services. Please check directly with them.  If you request, we will provide you with an invoice upon receipt of payment.

Rates: $120 per 50 min session. Longer sessions prorated.



I accept cash, checks, VISA/MC/Discover/American Express and Pay Pal.

Visa/MC Discover

Please call 425-417-5902 to schedule an appointment or use the online scheduler.

 

 

Copyright 2015 Bellevue Family Counseling, LLC    Site Map


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