Intensive Consent & Financial Forms

Good Faith Estimate of Scheduled Services:

This section provides you with a Good Faith Estimate of what you can expect to pay for services offered by Jennifer McCarron LMFT, as required by the Federal No Surprises Act. This estimate may change based on your presentation, symptoms, needs, and agreements with your provider throughout the course of care. This is not a binding contract—only an estimate to help you understand expected costs.

IJennifer McCarron will review their session fee with you during your initial consultation and again during your intake session. If you have any questions about the Good Faith Estimate or your fee, please ask for clarification.  Fees increase annually to account for inflation and additional training.

Therapist session rates are based on experience, licensure, certifications, and skill set. If you and your therapist agree on a different rate, that agreement will be honored instead of the standard rates listed below.

As of January 1, 2026, Jennifer McCarron's therapy rates are:

$175 per one hour session, or any part thereoff, including check-ins

• $525 per intake assessement appointment (3 hours)

Note: Research indicates that a 5-day EMDR intensive is comparable to at least one year of weekly therapy, making it financially more efficient for many clients.

Payment Schedule: Half of the total cost is due as a deposit at the time of scheduling. The remaining half is due on the first day of the scheduled intensive.

You may request a re-evaluation of your expected length and frequency of care at any time. You will be informed promptly if expected costs change during treatment. Please reach out with any questions, uncertainties, or disputes regarding the cost of your care.

This Good Faith Estimate outlines the costs of items and services reasonably expected for your health care needs. The estimate is based on information available at the time it was created. It does not include unknown or unexpected costs that may arise during treatment. If complications or special circumstances occur, your total cost may increase.

If you are billed more than the amount listed in this Good Faith Estimate without receiving an updated estimate, you have the right to dispute the bill. You may contact the provider to request an updated bill, negotiate charges, or inquire about financial assistance.

You may also initiate a dispute resolution process with the U.S. Department of Health and Human Services (HHS). This must be done within 120 calendar days of the original bill. There is a $25 fee to file a dispute. If the reviewing agency agrees with you, you will pay the amount listed in the Good Faith Estimate. If the agency agrees with the provider, you will be responsible for the higher amount.

For more information or to begin the dispute process, visit www.cms.gov/nosurprises or call HHS at (800) 368-1019.

Please cancel or reschedule as far in advance as possible so your dates may be offered to another client. Intensive/Retreat deposit fees are non-refundable but will be applied to rescheduled intensive or retreat days.

By checking the box below, you acknowledge that you have read, understood, and agree to the items contained in this document.

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