Faith concerns are discussed only at the initiation of the client. If you do not wish to talk about spiritual or faith concerns, you can rest assured that your wishes will be respected.
Therapy sessions may last either 45-52 minutes or 53-60 minutes, depending upon the need. In general, sessions are on a weekly basis; you and your therapist will likely settle on a regular day and time for your appointments.
If you are unable to keep a scheduled appointment, please notify the office at least 24 hours in advance. A standard session charge is made for cancellations with less than 24 hours notice. Please note that
insurance coverage will not reimburse for non-cancelled appointments. If you must cancel without 24 hours notice due to unforeseen emergency situations, please discuss this with your therapist at your next appointment.
Intake Forms
Before your initial visit to the Samaritan Center, you will need to fill out several forms. Generally, we ask that you arrive approximately 30 minutes before your appointment in order to give you plenty of time to complete the
necessary information. However, if time is a factor, you can request these forms and complete them prior to your appointment. This information can be sent via email (as a PDF), fax, or standard mail. You can also click
HERE to go to a page on this website to download the forms.
Each person participating in the sessions will need to have these forms filled out before the session. Parents/guardians will need to supply information for children under 18 years of age.
Initial Questionnaire — This form is a starting point for the therapist to get an idea of the issues that lead you to seek treatment. This will help the therapist establish what approach may be most effective.
Privacy Practices at the Samaritan Center — You will receive a copy of the Notice of Privacy Practices at the Samaritan Center which you may keep for your records.
Permission to Share — We cannot give out any information about clients without prior written permission. This form will allow you to designate certain persons with whom we can speak, and to specify what kinds
of information we can share with them. This form is particularly important if a third party will be involved providing payments, or if others will be involved in scheduling your appointments.
Individual History
As your sessions progress, your therapist will “take a history,” which means asking you to walk through the story of your life. This process is important because it is not unusual for important issues or sources of
problems to be hidden from awareness. In other words, a problem that seems clear-cut may have hidden complexities. A part of your therapy may be to discover these unknown elements and learn how they affect your situation. Once these
underlying issues are identified, realistic and long-lasting solutions can be created to address them.
Fees & Fee Assistance
A standard fee is charged for each session and payment is expected at the start or close of each session. In some cases, we are able to offset the cost of counseling for those individuals with demonstrated need, through generous
funding from dontations. You will be informed about our Fee Assistance Program by our administrative assistant when you call the Center. You will want to fill out the form before scheduling your first appointment.
We accept many forms of health insurance and will be happy to file on your behalf. You are responsible for paying your co-pay or co-insurance payment. We do not accept Medicare or Medicaid.
Payments can be made using cash, check, MasterCard or Visa. Payments are also accepted on Paypal.
The Samaritan Center
The Lee Martin Center
Elkhart, Indiana 46514
telephone: 574-262-3597 fax: 574-262-3599
e-mail: [email protected]