New Client Information
Frequently Asked Questions
A. Dr. Galloway and her associates will conduct play therapy with children as young as age three. If you have concerns about your child who is younger than the age of three, we will work jointly with you and your child in a format similar to play therapy called filial therapy.
A. Dr. Galloway is not in-network with most insurance companies but is able to work as an out-of-network provider on a variety of insurance panels. You can contact your insurance company directly to see if Dr. Galloway is an out-of-network provider. Dr. Galloway’s associates offer reduced fees for clients who qualify.
A. As a licensed professional counselor in the state of Texas, Dr. Galloway is accepted as an out-of-network provider for most insurance companies. At the conclusion of your session, she will provide you with a receipt to be used for reimbursement purposes. If you wish to use your out-of-network benefits, it is essential that you contact your insurance company and verify your specific benefits. You will be responsible for the full fee at the conclusion of each session and may opt to work with your insurance company to receive reimbursement. Although reimbursement rates vary according to insurance companies, many clients are reimbursed between 30% and 50% of Dr. Galloway’s fee.
A. You may click on the appropriate link below to access intake paperwork for adults and children. You may also access more information on the logistics of play therapy and the form to authorize the Galloway Counseling Center to release information below.
Please have the following forms completed and with you when you arrive for your intake appointment.
- Policies and Procedures Consent for Treatment Services
- Notice of Privacy Practices
- New Client Intake Form
- New Client Document Checklist
- How Medical Information Used
- HIPAA Authorization Form
- Consent For Minor Child
- Advisement Form
- Acknowledgement Privacy Practices
- Any current court orders (if the client is a minor and/or if you or your child are court-ordered to participate in therapy.)
- A file-stamped copy of your entire divorce decree (if you are divorced, and the client is your child.)