Tree Branches with Algae - Corvallis, OR - Michael Stattel MA LPC

New Patient Forms

To help facilitate the initial meeting, new client forms are to be downloaded here in PDF format. This allows you to print them out, complete and sign the forms prior to your first visit. For sessions taking place in my office download the disclosure agreement and client intake form.


For telemedicine sessions the completed and signed forms must be scanned and emailed to my office prior to your first session. All three forms are to be completed for telemedicine sessions.

Emergencies:

 

In case of a mental health emergency, please call my work cell number at (541)660-7187. You may leave messages at this number 24 hrs./day. I do not see people in emergencies without an appointment. If you are unable to reach me immediately in an emergency, please call the 24 hr. Crisis Hotline at (541)474-5360 (Josephine County) or (541)774-8201 (Jackson County) or (888)-232-7192 (Benton County/Corvallis) and ask  for a crisis worker. For life-threatening situations, call 911 or go to the nearest hospital emergency room.

My customary fees for services are $175 for the initial session and $150 for each additional session. A sliding scale from $100 to $140 is available in some cases. Payment is expected at the time of service. Sessions are 50” to 60” long and are scheduled by appointment. I am almost never available without an appointment. It is recommended that you always call rather than drop by the office, as the office is not set up to notify me that you are present in the case of unscheduled visits. Should phone consultations be necessary, the charge will be prorated to 15” intervals. There is no charge for appointments cancelled 24 hrs in advance or cancellations due to unavoidable emergencies. No-shows will be charged a cancellation fee of $100.

Click on the link below to download and print the necessary forms for your first session.
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