45 Accord Park Dr. Ste. 25 Norwell, MA
45 Accord Park Dr. Ste. 25 Norwell, MA
Daniel J. Richard, Ph.D. Clinical Psychologist 125 Church St Pembroke, MA
Daniel J. Richard, Ph.D.Clinical Psychologist                                             125 Church St Pembroke, MA  

Contracts

We have provide downloadable forms for your convenience. Please print, complete, and bring them with you to your first appointment

 

 

 

Contracts & Forms
DJR Contracts and Forms 2023.pdf
Adobe Acrobat document [241.5 KB]

Please complete releases of information for your primary care physician and any providers of past mental health treatment or related treatment (e.g., neurology assessment) including telephone and fax numbers, before your first session.

Release of Information
DJR PDF Release of Information 2023.pdf
Adobe Acrobat document [65.7 KB]

Fee Schedule

MasterCard Visa American Express All credit cards Advance payment Cash on delivery Health Care Spending Accounts
MasterCard, Visa, American Express, Credit Card, Advance Payment, Cash, Health Care Spending Accounts

We provide fee-for-service in addition to accepting health insurance.

 

Please view my Psychology Today profile to determine if I am a provider for your particular health insurance.  I may also be able to provide services for other plans if you have "out of network benefits."

 

If you choose to use your health insurance, please verify your out-patient benefits  (including any deductible for the year) with your insurance plan prior to our first meeting (by calling the number on the back of your card).   Please bring your insurance card and copay to the first meeting.

Initial Appointment/Diagnostic Interview:

(50-60 min)

$325.00

Folllow-up Sessions:

(45-55 min)

$250.00

Extended Session:

(per 15 min)

$65.00

Group Therapy:

(90 min)

$100.00

Family Therapy:

(90 min)

$275.00

Psychological Testing/Evaluative & Consultative Assessment:

(per hr)

$325.00

Court Appearances inc. travel, waiting time, and expenses:

(per hr)

$325.00
Missed Appointment/Late Cancellation: $100.00
Record Request (per page): $0.50

 

Congress enacted a “No Surprises Act” which went into effect 1/1/2022. The act is described as “new federal protections against surprise medical bills that take effect in 2022. Surprise medical bills arise when insured consumers inadvertently receive care from out-of-network hospitals, doctors, or other providers they did not choose.” ( https://www.kff.org/health-reform/issue-brief/no-surprises-act-implementation-what-to-expect-in-2022/).


It is highly unlikely this could affect our work together. There will be no situation in which you would “inadvertently” receive care from me or with no choice. Also, the final rules about how to implement this in a practice such as mine have not even been written yet by the federal government. You may read more about this at  https://www.cms.gov/nosurprises.


If we currently work together, you are already aware of my charges and your costs. If you are considering working with me, available information suggests I might need to provide you with a diagnosis before we even meet, which of course would be both unethical and impossible without a meaningful evaluation of your circumstances. At this time, multiple professional organizations are working to understand the details of this law, to whom it applies, and how to apply it. Guidance so far is uncertain and in many cases conflicting.  Rest assured that I will be as transparent with you about the costs of the services we agree on together. These are listed in the fee schedule above. 

Print | Sitemap
Copyright 2009 Daniel J. Richard, Ph. D. Material on this website is for informational and/or educational purposes only and is not intended to provide or be a substitute for professional services. Use of this website does not establish a therapeutic relationship.