Forms & Fees
Fee Summary
| Service | Fee |
|---|---|
| Child Custody Evaluation | $4,000 flat base rate per party, due prior to beginning the process |
| Parenting Facilitation | $1,500 retainer per party, due prior to beginning services |
| LCSW Supervision | $75 per session (weekly, one-hour individual meetings) |
| Counseling | Contact us for current session rates |
Complete fee schedules for each service are available in the PDF forms below.
Child Custody Evaluation Forms
- Sample Order for Preparation of Child Custody Evaluation
- Introduction Letter regarding Child Custody Evaluations
- Child Custody Evaluation Advisement Form
- Child Custody Evaluation Fees Schedule
- Child Custody Evaluation Personal History Intake Questionnaire
- Parenting Reference Questionnaire
- Notice of Privacy Practices
- Notice of Privacy Practices Receipt and Acknowledgement of Notice
Adoption Evaluation Forms
- Sample Order for Preparation of Adoption Evaluation
- Introduction Letter regarding Adoption Evaluations
- Adoption Evaluation Advisement Form
- Adoption Evaluation Fees Schedule
- Adoption Evaluation Personal History Intake Questionnaire
- Parenting Reference Questionnaire
- Notice of Privacy Practices
- Notice of Privacy Practices Receipt and Acknowledgement of Notice
Parenting Facilitation Forms
- Sample Order for Parenting Facilitation
- Introduction Letter regarding Parenting Facilitation
- Parenting Facilitation Advisement Form
- Parenting Facilitation Fees Schedule
- Parent Facilitation Intake Questionnaire
- Notice of Privacy Practices
- Notice of Privacy Practices Receipt and Acknowledgement of Notice
- Informed Consent for Telehealth Services
Counseling Forms
- Client Therapy Intake Form
- Therapy Advisement Form
- Notice of Privacy Practices
- Notice of Privacy Practices Receipt and Acknowledgement of Notice
- Informed Consent for Telehealth Services
Please contact Mindy Harrison directly or call 817-966-5401 if you are looking for a different form.
