Required Forms

Required Forms

March 20, 2020

COVID- 19

Notice to Clients

Beginning Monday, 3/23, the office will be closed temporarily and to ensure that there is limited disruption in your mental health care, I will be offering Telehealth sessions at your usual appointment time. Keep in mind that this format of therapy will be temporary as the Coronavirus will one day pass. To prepare for your session, you will need to find a quiet area (if possible) where you feel comfortable. If necessary, use headphones that will help with reducing noise and distractions.

I also recognize that your schedule may look different now that we are all encouraged to limit travel; please let me know if you would prefer a new appointment time. To attend a virtual video session, please use the following link at the time of your appointment:

https://doxy.me/charmaine. Click on the link, type in your name and then click on “check in”.

Clients whose insurance is Anthem, BCBS, United Healthcare, Oxford, Connecticare, Cigna and Magellan; please contact your insurance company to inquire if Telehealth is a covered benefit. Copayments and deductible payments may be made at the end of each session via the doxy.me Telehealth platform.

Please check out the following article to get some tips on how to better manage stress and anxiety: https://www.goodtherapy.org/blog/15-self-care-activities-you-can-do-at-home-during-covid-19-0318204

I will see you online soon. Be safe!

Best regards,
Charmaine Samuda, LCSW

Release of Information Consent
Payment Contract for Services
Client Information Sheet
Provider or Self-Referral Form
Financial Policy