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Informed Consent

Feel free to print, complete, and bring this informed consent form with you for your Initial Appointment.


I am a "fee for service" provider"*.  That means you are directly responsible for all payments for therapy. If you have PPO insurance, the relationship is legally between you and your insurer.  The majority of my patients with PPOs receive reimbursements by their insurers. Out-of-network mental health services are required by law to be reimbursed at the same rate as other out-of-network medical services.   

*If you are a Caltech student, my services are covered 100% by your Caltech student health insurance without any co-payment.  


Payment Methods

  • Cash

  • Check

  • Zelle (323) 819-4181

  • Venmo (@Kris-Yi-2)

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