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Woman Conversing Calmly

Request Appointment

Please fill out the following form to request an appointment.

Topic areas that you are looking to address with your clinician.(Check all that apply to you)

Appointment & Payment Policy

To reserve your appointment, a valid card is required to remain on file. This helps us protect your scheduled time and maintain a smooth billing process.

Insurance & Payment Information

If you plan to use insurance, your insurance information must be submitted at least 48 hours prior to your appointment so we can verify coverage and benefits.

If insurance information is not received within this timeframe, your session will be billed at the private pay rate.

Please note:

• Telehealth coverage varies by plan. We recommend confirming virtual benefits directly with your insurance provider.
• Copayment and coinsurance estimates are based on benefit verification and are not a guarantee of payment.
• If your insurance denies or does not remit payment for services rendered, you are responsible for the remaining balance.
• Please notify us promptly of any insurance changes to avoid claim delays or denials.

Your out-of-pocket responsibility is determined by your individual insurance contract.

Cancellation & Attendance Policy

We understand that unexpected situations arise. To support planning, we provide both 48-hour and 24-hour appointment reminders.

• Appointments must be canceled or rescheduled at least 24 hours in advance.
• Late cancellations (within 24 hours) will be charged the full out-of-pocket session rate.
• No-shows will incur a $75 missed appointment fee.
• Clients arriving more than 15 minutes late may be marked as a no-show and charged accordingly.
• If your clinician is more than 15 minutes late, you will be contacted and may reschedule at no additional charge.

Refunds are not provided for missed or late-canceled appointments.

To cancel or reschedule, please contact our Office Manager at thrivenation@thrivefocuscounseling.com

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