Yasir Ahmed 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 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.

Wait!

We offer a live online Mindfulness-Based Stress Reduction and IFS course for couples.
Meets every Thursday 12-2pm EST, July 15 - August 26, 2021

A HUGE savings compared to couples therapy

Learn More →
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