We believe Black lives matter. Our hearts and minds are united with our Black counselors, clients, family, and neighbors to seek social justice, restorative justice and build relationships that will heal the legacy of inequality in our country.

Keith Miller Forms

I look forward to meeting with you very soon. Please complete the forms below and email them back to me prior to the first session. 

PAYMENT: Payment is expected prior to our first session and will be thereafter charged on the day we meet. Please submit a payment in the amount your counselor specifies. The fee for reserving your appointment with me are considered due 24 hours prior to your appointment time. Cancellations prior to this 24-hour-before-your-session point incur no charge. 

The following forms are REQUIRED for meeting with Keith Miller:

Client Data Form and Consent for Care – Keith Miller

Client-Clinican-Agreement-Form-Keith-Miller

 

The following forms are OPTIONAL and used only when needed

Consent for Release of Information

Our psychotherapy fees start at $175 per hour (psychiatry fees start at $200 for 30 minutes).
We do not accept insurance, meaning we are not "in-network" with any health plans.
However, many of our clients submit claims to their out-of-network health insurance and receive 40-60% reimbursement.