Thank you for choosing Principle Skills Relationship Center.

Forms for New Clients

These forms are for private therapy clients. Your therapist may direct you to download, print and fill out these forms; or your therapist may provide you with electronic forms to complete.

Intake
Form

Gottman Therapy
Overview

All Intake Forms will be sent to clients via our secure HIPPA compliant EHR portal to be completed and signed, once an appointment has been scheduled. Please complete these forms promptly upon receipt.
Who You’re Seeing How Many Years of Experience Individual Intake Rate Individual
Rates
Couple Intake Rate Couples
Rates
Intern 1-3 years $135 $90 $225 $135
Candidate 3- 5 years $180 $120 $300 $180
Mid-Level Career 6-14 years $255 $170 $425 $255
Experienced 15+ years $360 $240 $600 $360
Who You’re Seeing
How Many Years of Experience
Individual Intake Rate
Individual
Rates
Couple Intake Rate
Couples
Rates
Intern
1-3 years
$135
$90
$225
$135
Candidate
3- 5 years
$180
$120
$300
$180
Mid-Level Career
6-14 years
$255
$170
$425
$255
Experienced
15+ years
$360
$240
$600
$360

Mandatory Disclosures

Important information is disclosed here as part of our mandatory disclosure process to ensure transparency.

Mandatory Disclosures & Rates

Caralee Frederic

Mandatory Disclosures & Rates

Amanda Linan

Mandatory Disclosures & Rates

Christianne Davis​

Mandatory Disclosures & Rates

Lisett Walp

Messaging Terms & Conditions

Upon scheduling, you agree to receive informational messages (appointment reminders, account notifications, etc.) from Principle Skills Relationship Center. Message frequency varies. Message and data rates may apply. Email us at kristi@principleskills.com or adjust the privacy settings in your client portal.

Messaging Privacy Policy

No mobile information will be shared with any third parties/affiliates for marketing/promotional purposes. All other categories exclude text messaging originator opt-in data and consent; this information will not be shared with or obtained by any third parties.

If you wish to be removed from receiving future communications, you can opt out at any time contacting us at kristi@principleskills.com

Insurance

We are out-of-network providers for insurance companies. If your insurance plan includes out-of-network coverage, your insurance provider may partially reimburse you. We provide you with a coded document in your portal (also referred to as a Superbill).

Principle Skills Relationship Centers can’t provide services to individuals who have Medicaid due to the contractual agreements between the patient and Medicaid. If you have Medicaid, you must seek mental health services from a Medicaid provider. We are not an in-network provider with Medicaid and Medicaid does not allow subscribers to see out-of-network providers. If you have Medicaid, please contact them or visit their website for in-network providers.

Intake Charges

Intake charges are an on-time, initial charge that is slightly higher than a normal session rate because of the extra time required by the therapist to do data analysis, create a treatment plan, and enter everything into the system.

Payment

Payment is due on the date of service. Credit/Debit/Venmo/HSA/Flex-Spending forms of payment are accepted.

Cancellation Policy

Please notify us at least 48 hours before your appointment if you request a change of schedule or cancellation. Exceptions are made for uncontrollable circumstances and health-related emergencies.