Client Forms
New Clients
Forms can be e-mailed to admin@maitrichicago.com
Please complete our Intake Packet
Please download and read our Notice of Privacy Policy
Review and submit our Consent for Treatment Via Telehealth Form prior to our first remotely scheduled appointment
Review and sign our Informed Consent
Complete a Release of Information Form if you wish for us to communicate with anyone
Family/Couple Clients: Review and sign our Family/Couples Therapy Addendum
Adolescent Clients: Review and sign our Adolescent Addendum
FAQs
Are you in network with insurance?
We are in network with Blue Cross Blue Shield PPO, Aetna PPO, and United Healthcare (Optum).
Can you help me figure out my insurance?
Yes! If you’re having trouble discerning whether or not we are in network with your plan, please reach out via the Contact Us form and we can help you figure out whether we are in network or not.
How do I know if therapy is right for me?
There are any number of reasons individuals choose to participate in therapy. If you’ve considered reaching out, it’s likely that therapy might in fact be beneficial. The best way to know if you could benefit from therapy is to schedule an initial appointment and find out! We encourage clients to ask us questions and “interview” us. There is nothing more important in the therapeutic process than feeling a sense of safety and connection with your therapist. Meeting with us and asking your questions might give you a better perspective on whether or not therapy with us is the right fit for you.
What if Maitri Psychological Services is out of network with my plan?
Many plans offer a lower reimbursement rate for out of network providers. You may be eligible for a portion of your sessions being reimbursed by your insurance even if we are out of network. You can contact your insurance provider to get more information about your out of network benefits. Please note that you will be responsible for paying us and we will provide you with invoices that you can submit to your insurance for reimbursement. We can also work 1:1 with clients to identify a sliding-scale fee if needed.
What kind of things can therapy help with?
Therapy can be a way to navigate any challenge you might be experiencing in your life. These include: stress related to external factors, mental health diagnoses you might have received, relational conflict, a sense of being lost, trying to cope with current social/political issues, navigating a difficult transition, anxiety about the future, grief related to a loss, and many more. We are happy to schedule a brief phone call through which we might be able to better guide you based on your specific situation.
What if I don’t have insurance?
We have a limited number of slots for sliding-scale therapy clients for those who are experiencing financial hardship. Contact us to find out if you qualify for our sliding-scale option.