Notice of Right to Receive a Good Faith Estimate

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services.

• You have the right to receive a “Good Faith Estimate” explaining how much your therapy services will cost.
• My fee is $150 per 50-minute session.
• The total cost of services depends on the number of sessions you choose to attend.
• You will receive a written Good Faith Estimate before your first session, and you may request one at any time.

For questions or more information about your right to a Good Faith Estimate, visit https://www.cms.gov/nosurprises.