DIANE GLEIM LICENSED MARRIAGE AND FAMILY THERAPIST AASECT CERTIFIED SEX THERAPIST & SUPERVISOR
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Individual & Couples Sex Therapy

Fees

Individual Therapy - $175 per session. Generally sessions are 50 minutes long unless we make other arrangements.
Couples Therapy - $175 per session. Generally sessions are 50 minutes long unless we make other arrangements.

I do not accept insurance. You may be able to get partial reimbursement from your health insurance company for our sessions. It is your responsibility to check with your specific insurance company to find out if you have an “out-of-network benefit for mental health services”. If so, I can provide you with a statement (a.k.a. Superbill) for reimbursement.
PLEASE NOTE: As of June 2021, I am now seeing some clients over Zoom (teletherapy) and some clients in-person.
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Please review this form to see if teletherapy is right for you:   
​    Teletherapy Considerations for Clients
New Client Paperwork
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​Once we have scheduled an appointment I ask all new clients, including initial assessments, to complete the forms below.  If any question is confusing or does not apply to you, simply leave it blank.

​       Client Contact Sheet
       2022 Informed Consent
       Teletherapy Informed Consent
       General Questionnaire
       Sexual Health Questionnaire
​       Authorization to Release Confidential Information
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No Surprises Act/Good Faith Estimate Information:

       No Surprises Act/Good Faith Estimate Notice
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Contact Me
DIANE GLEIM  
LICENSED MARRIAGE AND FAMILY THERAPIST 
​​LIC #44429 / AASECT CERTIFIED SEX THERAPIST & SUPERVISOR 
​SONOMA COUNTY, CA
320 10th Street, Suite 302,
​Santa Rosa, California
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