Forms
Links to online forms and/or printable and fillable PDF forms:
New Client Inquiry Form
Link
Notice of Privacy Practices
Link
PDF
Fees
Initial consultation (~15 minutes, by telephone): Free
Individual therapy session (55 minutes, by secure audio/video link): $150.00
Individual coaching session (55 minutes, by secure audio/video link): $150.00
Insurance
Levamentum does not currently accept insurance for therapy or coaching. Depending on your insurance coverage for behavioral health, Dr. Hruby may be considered an out-of-network provider, and thus, some portion of therapy fees may be covered.
Cancellations
Notify Levamentum by email or voicemail if you need to cancel your scheduled appointment. Cancellations within 24 hours of a scheduled appointment or a no-show will be charged the full session fee.
Payment
Payment is by credit or debit card, Venmo, PayPal, or personal check. Levamentum reserves the right to discontinue services for lack of payment. If you choose to pay by credit card, please complete and submit the Credit Card Authorization Form. You may pay for sessions online (via Venmo or PayPal) via the Payment portal.