The following forms are standard intake documents that contain information about our clinic's policies, procedures and confidentiality statement. Please feel free to complete these forms and bring them with you to your first appointment. Our staff will be happy to review them with you and answer any questions that you may have. If unable to print these forms, you will need to arrive 20 minutes early so that may complete them before your first appointment begins.
At Gramercy Specialty Clinic, we understand that cost can at times be a barrier to treatment, so we work with each client individually to develop a cost-effective payment plan. We never turn any individual away due to financial limitations and offer a sliding fee scale option for clients seeking counseling services who are currently uninsured. We also offer limited pro bono counseling services to individuals and families who meet criteria and are facing significant financial hardship.
Gramercy Specialty Clinic is committed to providing affordable care and it provides a multitude of payment options to cover the cost of services. We currently accept a number of insurance plans, and also provide out-of-network services. Our staff works directly with the insurance companies as a courtesy to our clients, and are happy to provide cost estimations regarding copay/coinsurance fees upon request. If you would like more information about your direct costs for services, please call our clinic and our staff will be happy to provide you with cost estimates, as well as match you with a health care provider that best meets your needs!
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