CLIENT INFORMATION
Office Location
My clinical practice is located at 115 West Arrellaga Street, in the heart of downtown Santa Barbara and easily accessible from Ventura County to North Santa Barbara County. The office is wheelchair accessible and ample parking is available on the street.
Fees and Payment
My standard fee is $200 per session. I accept check or cash only. There may be some opportunities for fee reduction when there is financial need. Please feel free to discuss this with me when you call for an appointment.
I have a restricted number of appointments available for insurance holders. If you wish to use your insurance, please let me know when you call so that we can determine if there is an opening in my practice. If I am not on the Preferred Provider panel of your insurance provider, I can provide you with a Superbill for you to submit to your insurance company.
I require 24 hours notice of cancellation, or you may be billed for the missed appointment.
For more information on Office Policies, please download the Consent for Treatment form at the bottom of this page.
Confidentiality
In accordance with the Health Information Privacy Act (HIPAA) your personal health information is considered protected and, as such, will only be used or disclosed for the purposes of treatment, compensation, and healthcare operations and will otherwise not be released without your specific authorization. Exceptions to confidentiality include: (1) if you are a risk to your own safety or to the safety of others; (2) if you have hurt a child or an elder; (3) if the court has a legitimate subpoena to impound my records; (4) if you are in a lawsuit where emotional harm is being claimed; (5) if you elect to use insurance coverage.
Preparing for your first session
1. Please come prepared for your first session by completing and bringing with you the Office Policies and Consent for Treatment form and the Intake Form below. Completing this paperwork ahead of time allows us to use our first session more productively.
| Consent for Treatment |
| Client History |
2. Payment is due at time of service. You may pay by cash or check. I do not accept credit cards.
3. If you are using insurance, please bring a copy of your insurance card with you. Make sure that you understand what your deductible and copay responsibilities are before you arrive by contacting your insurer.
4. When entering the waiting room, please turn on the switch next to my name so that I know that you have arrived. I will be with you shortly.
For more information contact Dr. Jan Rudestam at jrudestam@cox.net or call (805) 569-2540.
3. If you are using insurance, please bring a copy of your insurance card with you. Make sure that you understand what your deductible and copay responsibilities are before you arrive by contacting your insurer.
4. When entering the waiting room, please turn on the switch next to my name so that I know that you have arrived. I will be with you shortly.
For more information contact Dr. Jan Rudestam at jrudestam@cox.net or call (805) 569-2540.
