HERE - SociAbility Chicago

SociAbility Rates
Group intake session One hour
Pre-Group Sessions One hour Sessions
(Prior to starting Groups)
Group rates
Per Semester
Thursday/Saturday groups
Summer 2017 (75-minute Session)
Summer 2017 (60-minute Session)
Monday groups
Summer 2017 (75-minute Session)
Summer 2017 (60-minute Session)
$150
$150
$1,160 (8 sessions)
$1,040 (8 sessions)
$1,015 (7 sessions)
$ 910 (7 sessions)
Individual Therapy Rates
Initial consultation
One hour
$300
Therapist
Genevieve Thornton, Psy.D
Noah Bach Bar-Tura, Psy.D
Carly Walder, Psy.D., LLC
Lorra Rudman, M.A., N.C.C., L.P.C.
Sara LaMontagne, MA, MSW, LCSW
Stacy McCarthy, J.D., L.P.C.
Melissa Dore, B. A.
$250
$180
$180*
$150
$150
$150
$100**
*Accepts Blue Cross/BCBS
** In-home behaviorial therapy
Summer 2017 Payment Schedule
We offer a fee schedule of two (2) payments payable each month for the summer.
We will offer two options, you can provide a credit card to be kept on file and your payments
will be processed on the first of each month June 1st and July 1st. Or we request that you
provide two (2) checks to be deposited with us on each of the above dates.
60 minute classes are $1,040 per session = $520 for each payment
75 minute classes are $1,160 per session = $580 for each payment
Sincerely,
The SociAbility Team
899 Skokie Boulevard, Ste 204
Northbrook, IL 60062
www.sociabilitychicago.org
Tel: (847) 559-3240
Dear Families:
It is now time to sign up for summer groups! This year our summer session
will begin June 17 th and continue through August 12th. (No groups July 1st
through July 5th -see website for details).
Please sign the enclosed paperwork and return to Karyn Lerner
at [email protected] or call (847) 559-3240 by May 28th to
guarantee your spot. These groups are highly desirable and we will start
filling spots with new clients. Please do not risk losing your spot or having
the group cancelled if you do not respond by this date.
For new clients, sign-up requires an initial assessment and interview that
has a fee of $150 to determine appropriate group placement. Additionally,
we require four (4) therapeutic coaching sessions ($150 each) to assess
your child’s strengths and challenges and to introduce them to the
foundational skills that are practiced throughout the summer. It also helps
the new group members prepare to join members who have already
participated in our program. No groups will have more than 6-8 members.
No more than 5 participants in groups for children 10 years and under.
Waitlists will be implemented when groups are full.
The cost for the eight (8) weeks session is $1,040 for 60 minute groups and
$1,160 for the 75 minute session. Because of the July 4th weekend, there
are only seven (7) sessions for the Monday groups. The cost for the
Monday sessions is $1,015 for the Adult group and $910 for the Kidlings
group. All groups are commitments for the entire semester. Our group
success is based upon the consistent participation of each member a along
with parent education and training to ensure generalization of skills. We
work very hard to establish relationships amongst our group members and
continuity and attendance is absolutely essential to each child’s progress in
the group. We will not refund payments for missed sessions.
Yes, I agree to sign up my child/adolescent for the summer groups at
SociAbility. Please sign this form and return it to our office with full
payment. Signed form and payment must be received to guarantee
your spot.
Child/Adolescent name:
________________________________________________
Parent/Guardian Signature:
___________________________________________
We are so excited to work with our families toward our 9th successful year
of social thinking groups!
899 Skokie Boulevard, Ste 204
Northbrook, IL 60062
www.sociabilitychicago.org
Tel: (847) 559-3240
Payment Authorization
For your convenience, and to guarantee payment for services rendered, we require documentation of a major
credit card. Otherwise, payment must be made at time of service.
I authorize SociAbility, L.L.C. to keep my signature on file and to charge my credit card account listed below at
time of service. I understand that this authorization is valid until I cancel the authorization through written
notice to the health care provider.
Card types:
o Visa
o Master Card
o Credit
o Debit
o Discover
Account number_____________________________________________
Expiration Date______________________
Security Code_______________________
Patient Name: ____________________________________________________
Card Member Name:_______________________________________________
Address: ________________________________________________________
City: _______________________________ Zip Code: ___________________
Telephone:_______________________________________________________
Card member signature:_______________________Date:____________________