Forms and Logistics for the Somatic Psychotherapy practice of Fern Snogren, LCSW, MA, CHT

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Clients

Professional Disclosure Statement

New Client Info Form

Insurance Information Form

In-Network Insurance Use and Billing Agreement

Out-of-Network Insurance Use and Billing Agreement

Release of Confidentiality

Professional Disclosure Statement for Non-Clients

Supervisees

Clinical Supervision Professional Disclosure Statement

Payment Options

Insurance billing for insurances with which I am in network:

AllCare PEBB

Asante

Blue Cross Blue Shield

Bridgespan/Real Value

Coventry

First Choice

Health Comp

Health Net (MHN)

OHP: Jackson Care Connect & AllCare

Medicare & all Medicare Advantage Plans

Pacific Source

Regence Medicare Advantage (MedAdvantage PPO)

Reliant EAP (includes Samaritan & Asante)

Tricare

Wellness 2000 EAP

Monthly superbills for clients with insurances with which I am not contracted

Some sliding scale available

Fees are reviewed and established annually and are available upon request.

Session Length

Sessions range from 45 to 80 minutes, depending on client needs, affordability, and the specific nature of work we are doing.

More Information

For more information on the logistics of my practice, please consult my Professional Disclosure Statement or feel free to call 541-482-3328 or email info@fernsnogren.com.