"You must be the change you want to see in the world."

— Mahatma Gandhi

Information for Individuals, Couples, and Familes

Our location:  Vanport Square, a redesigned green building in Northeast Portland.

Forms

All new clients must complete an intake and financial form before the first meeting.

Adult Client Intake Questionnaire

Couples Intake Questionnaire

Child & Adolescent Intake Questionnaire

Financial Agreement Form

Financial Policy

All payments are due in full by cash, check, or credit card at the beginning of the session unless other arrangements are made.

Self Payment Discount

We offer a 20% discount for payment in full at the time of service for clients who are not using insurance. There may be other benefits of cash payment for services, including increased confidentiality and freedom from the requirement that a mental health diagnosis be applied to you or your family member (necessary to obtain insurance reimbursement).

Insurance panels

Dr. Thomas Doherty is a Preferred Provider with Regence Blue Cross of Oregon and ODS Health Plan. Other insurance companies may reimburse for his services. Insurance plans vary and it is important to contact your insurance provider and clarify your benefits. If you have questions about about your benefits, please contact our billing specialist: Sharon Madden (503-704-3958).

Financial Aid

Financial aid may be available for those with demonstrated need and for full time students. Please contact us for a financial aid form.

Billing Questions

Please direct questions regarding statements, balances, and insurance reimbursement to our billing specialist: Sharon Madden (503-704-3958).

Fees for Counseling & Therapy

Sustainable Self Fees and Financial Policies Handout January 2010