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Services, Fees And Forms

My fee is $120 per hour. I usually see individual clients for one hour appointments weekly. If a client would like to set up a different schedule I will work with them to come up with a unique plan, depending on the client's needs. Please call my billing company, MindEase Billing 971-533-9911 to verify your insurance benefits.

Couples sessions are generally one hour but sometimes 75 or 90 minutes works better for couples. I charge $150-180 for the longer sessions. Most couples I see for a minimum of 20 sessions and generally I see couples weekly.

I charge $120/hour for supervision/consultation but I do have a few sliding fee spots. I charge less for group supervision - usually $60 per person in the group with a maximum of 6 in any group.

Business coaching is usually done on a one year contract either weekly or bi-weekly and my fee ranges from $250-500 per hour depending on the complexity of the situation. A one year contract is necessary for accountability since often the habits we are trying to change require focus, commitment and time.

Many clients either pay each session or prefer to be billed at the end of every month. I will bill insurance for a client, although my fee is the responsibility of the client. I accept Medicare. I ask for 24 hour notice for cancellation so that I can fill the session, but if a client is ill then generally if we can reschedule in the same week there is no charge for the missed appointment.

I do save a few slots for clients who need a sliding scale fee. Please let me know if this is your need so we can work together to try to come up with something that works for both of us.

  Instructions
  1. Fill out the Patient Name and Payment Description fields on the right


  2. Click the Pay Now button


  3. When on the PayPal site, enter the payment discussed in the Item Price field and click Update


  4. Submit your payments using your PayPal account or any of the major credit cards listed


Patient Name
Payment Description

Forms

Intake Form

Consent to Release Information

Consent for Treatment
These forms use Adobe Acrobat PDF Reader. Click the link below to download Acrobat if you do not have it already installed.



   Jean Shirkoff
   Certified EFT Therapist & Supervisor
   Phone: 503-222-1807
   Fax: 503-297-0885
   1942 NW Kearney St Suite 12
   Portland, OR 97209
   Email: jean@jeanshirkoff.com


  • Couples EFT Therapy.
  • Family Therapy.
  • Individual Psychotherapy.
  • Business/Executive Coaching.
  • Supervision, Consultation.

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