New Patient Form
The questions below are intended....
All new patients should fill in and submit the form or pdf below. |
New Patient information
New Patient Questionnaire
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For information or to arrange an appointment:
Please call Hazel at 707-787-7772 Session details: $125 for a 90-minute session (office visit, phone, Skype or Facetime) $550 for a package of 5 sessions (valued at $625) Sliding scale available Office location: 9550 Willow Avenue Cotati, CA 94931 Payment: Cash, check or credit card. For remote sessions, please mail a check to: Pam Rowen-Herzog, 9550 Willow Avenue, Cotati, CA 94931 |
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Venmo
pamela-rowen-herzog |
Paypal
pamrowenherzog@gmail.com Please choose the friends and family payment option or increase your payment by 3%. |
Square
pamrowenherzog@gmail.com Please increase your payment by 3% to cover Square fee. |