Forms

Prior to your first scheduled appointment, please fill out the Intake Form to the best of your ability and read and sign both the Informed Consent form and the HIPPA form. By completing these forms prior to our appointment, we will be able to use your appointment time more wisely. To download the forms, simply click on document below. 

Denise is an in-network provider for Premera, Regence Blue Shield, Kaiser Permanente.  Sessions typically run either 55-60 minutes or 80 minutes, and fees range from $150 - $200 (for couples). Call or email with specific inquiries or pricing questions.

 

Payment is due at the beginning of each session. Cash and checks are accepted, and credit cards (for an additional $3 transaction fee).  Upon request, paperwork will be provided to submit to your insurance company for possible reimbursement.

Informed Consent
Telehealth and Email Agreement

Contact Denise Kuyper

Licensed Marriage & Family Therapist  

300 NE Gilman Blvd

Suite #300

Issaquah, WA  98027

425.891.4994