Location
509 Marin Street, Suite 236
Thousand Oaks, CA 91360
Phone:
805-405-8994
Fax:
805-426-8096
Please note that this is an electronic fax number that goes directly to Dr. Katz’s email box. As such, you do not need to enclose a cover sheet.
Insurance Statement
Please note that Dr. Katz is currently a contracted provider with a small range of insurance panels. Do be aware that you are ultimately responsible for charges that are incurred. At the end of each session, you will be provided with an industry-standard superbill that can be used to obtain out-of-network coverage, if necessary. We would be happy to discuss your insurance co-pay and coverage limits prior to beginning work with you. If finances present an obstacle to treatment, Dr. Katz would be happy to discuss this with you prior to beginning our work with you.”
Office Policies / forms
If you are seeking services for a child (under the age of 18), please complete this form: Child Patient Information Form. I will also need a consent to treat minor form completed by a parent or guardian authorized to sign legal paperwork on behalf of the child. You can find this form here: Consent to Treat Minor Form. If you have any questions about who is authorized to sign, please contact us.
If you are seeking services for an adult (over the age of 18), please complete this form: Adult Patient Information Form
My office policies form can be found here: Office Policies
The Health Insurance Portability and Accountability Act (HIPAA) documents can be found at this link:
Patient Agreement
HIPAA regulations require that I obtain your signature on this document as we begin our work together.
California law requires mental health care providers to distribute this form : California Notice Form. Do note that there is no signature on this form.”
A Note on Office Fees:
Fees for services are expected to be paid as they are provided. Dr. Katz accepts all major credit cards, cash, or checks. Prior to our work together, we will agree upon the fees charged. Dr. Katz has a standard set of fees for weekly psychotherapy, assessment batteries, forensic work, and consultation. These can be forwarded to you upon request.