Take the first step …

Get Started

When you submit the form below, you will receive an email with further information about our services, and our Intake Coordinator will contact you by phone to begin the intake process.

This form is for potential clients. All other inquiries, please see contact information at the bottom of the website page.

Please fill out the following:

I understand that Polaris can only provide psychotherapy and integration to those residing in California, Oregon, Montana, Michigan, and Colorado.

To those outside of these states, we can provide 1-3 paid consultations and provide a referral in an appropriate state of residence.

I understand that Polaris is an out-of-network provider.

Polaris is not contracted with any insurance company and does not communicate on behalf of clients with insurance companies.

KAP at Polaris is an out-of-pocket treatment. Patients may choose to submit superbills for reimbursement to their insurance company. We are happy to provide patients with procedure codes to get an estimate of what portions of treatment would be covered.

I have reviewed the fee structures and prices for Polaris services.

First intake session is $300 and follow-up psychotherapy/integration sessions are $250. Sliding scale may be available with MFT Associates.

First Name*
Last Name*
Email*
Best Phone Number to reach you*
State of Residence*
Please review the Requirements for Treatment (at the top of this page) before filling out below:*
- I understand that Polaris can only provide psychotherapy and integration to those residing in California, Oregon, Montana, Michigan, and Colorado.
- I understand that Polaris does not communicate with any insurance providers. This is an out-of-pocket treatment that I may be able to submit for reimbursement.
- I have reviewed the fee structures and prices for Polaris services.
- I am over 18 years old.

1

Submit the inquiry form

2

Review the information in the email sent to you.

3

Begin the intake process with a call from our team.