Forms

In an effort to save you time please print and complete the New Patient information form and bring it with you for your first visit.

Policies

Appointment Cancellations and Missed Appointments: 

 

We understand that schedules can change in the hectic lives we all lead. However, when you book an appointment, that time slot is reserved for you exclusively. A minimum of 24 hours prior notice is required if a cancellation or date/time change is necessary. The full cost of the appointment will be charged for any late cancellation or no-show appointments. Late arrivals will result in a shortened appointment. I apologize for any inconvenience this may cause.

 

Insurance


We do not participate in any insurance plans, however, many people find that services are covered through their out-of-network benefits. At each session we provide clients with an invoice to submit to their insurance provider for reimbursement. If you have any questions about insurance and treatment, please feel free to call or email us. We are glad to answer any questions and help guide you through the payment process.

 

Payment

 

Payment for services is due and payable at the time of visit, unless an individual exception has been discussed and agreed upon. Please contact us directly to obtain information about fees.

Contact 

Gitty Bronstein MS Ed., LCSW
682 Eastern Parkway
Brooklyn, New York 11213
 

Phone: 917-446-5444

E-mail: gittybron@gmail.com

Sample form
This is a sample form.pdf
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