Appointments

Rates

  • I charge $175 per 50 minute session. 
  • Payment is required at the time of your visit by check, cash or credit card (Visa, MasterCard or Discover).
  • I send a copy of your bill at the end of the month for you to submit to your insurance provider.
  • If you want a copy of your bill at the end of your visit, just remind me.

Cancellation Policy

  • You are responsible for payment of the agreed upon fee for any missed session(s). 
  • You are also responsible for payment of the agreed upon fee for any session(s) for which you failed to give me at least 24 business hours notice of cancellation. 
  • Please call before appointment time on Friday to cancel a Monday or the day after a holiday appointment. 
  • Cancellation notice should be left on my voice mail: (408) 371–4847

Insurance

  • While you are responsible for payment at the time of your visit, if you want to check and see what your insurance may reimburse you for out of network providers, you can call the 800 # on your card. 

    New clients always welcome.
    Please email Mary or
    phone 408.371.4847.

  • Tell them that you would like to see an out of network provider who charges $175 per session. 
  • Ask about how much they will cover…co-pays, maximum number of visits, amount they pay, and any applicable deductible.  It’s good to keep a written record of what they tell you.
  • They will probably ask you about the problem that you want to see someone for and you can generally describe any symptoms of adjustment, grief, anxiety or depression that you may be experiencing that caused you to call.

Number of Sessions

We will decide on the frequency of visits based on your unique situation.

 

Location

My office is in Campbell.  Click here for a map and a photo of the building.

 

Hours

  • Monday through Friday: 8:30 am - 2:30 pm

 

Forms

To save time on your initial visit, please print out and complete the two forms  below:

    (You will need an Adobe® Acrobat reader to view and print out the forms. If you do not have a reader, or are having trouble printing out the form, you can obtain a free and current copy through this link.)

  • Client Intake Form (pdf file; 45K) This form provides me with some general background information and contact information.
  • Client Consent Contract (pdf file; 26K) This Agreement is intended to provide you with important information regarding the practices, polices and procedures and to clarify the terms of the professional therapeutic relationship between Therapist and Patient.

 Updated 5/10/14

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Mary M Buxton LCSW, Inc. - Sex & Couple Therapy - Licensed Clinical Social Worker  #LCS 7780
15951 Los Gatos Blvd., #14, Los Gatos CA 95032 -  Phone: 408. 371.4847 -  Email Mary

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