Satu Korby
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512-800-4775
LPC-S
Forms/Rates

Forms


The following forms will be needed for the first counseling session. Please print and fill them out and bring to our first session. Or, I will have them available for you to fill out in the lobby, if you are unable to complete them ahead of time. If that is the case, please arrive 15 minutes early to your appointment so you will have time to fill them out.

For couples, please have each partner fill out her/his own form.

Please note, for divorced parents of minor clients, please bring a copy of the custody agreement and/or divorce decree so that I may verify whom may consent to treatment.
New Client Information Form MSK 3-2014.doc
click to download
Professional Disclosure Form/Informed Consent
click to download

Rates

 
  • For individual sessions - 50 minutes, the fee is $130.  
  • For couples sessions - 55 minutes, the fee is $175.
  • For group therapy - fee range is $50-$75.
  • I accept payment in the form of cash, checks and all major credit cards.
  • I am an in network provider for Blue Cross Blue Sheild. I can file that insurance for you.
  • I am not on any other insurance panels at this time, but I am happy to discuss out of network options with you. If you would like, I can provide you with a receipt with which you may choose to submit for reimbursement from your insurance company.
  • If you would like to use your insurance benefits, please contact your provider to verify your in network or out of network benefits before your first appointment.   

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