My practice is currently full, and I do not keep a waiting list.
To find local providers check the directory of the
North Coast Association of Mental Health Professionals at www.ncamhp.org
Existing Clients
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We like to make taking care of business as easy as possible. Both existing and potential new clients should contact Etta at 707-296-9939, via the "Contact" page, or at Etta@OutOfTheBramble.com.
Richard is the practice manager and your contact for billing issues, records requests, insurance issues, and other business-related items. Many of your questions can be answered below, but if you have additional questions or requests he'll do everything he can to meet your needs. The best way to contact him is via email at Richard@OutOfTheBramble.com. Include a brief summary of what you need and the best time and way to reach you, and you should receive a reply within 24 hours.
Payment
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In-Person: Payment can be made at the time of service by check or cash.
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Mail: You may mail a check payable to "Etta Bergstresser, LCSW" to P.O. Box 143, Bayside, CA 95524.
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Online: You can make payment by credit card and access your statements and invoices.
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AutoPay: To keep things simple you may enroll in autopay by using a credit card, which will be billed within 24 hours of a session.
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The "Portal"
For existing clients we have an online "portal" that will make doing business with us easier, allowing you to focus on other things. With the portal you can:
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Update your information or complete necessary forms.
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Access your account statements and invoices whenever you like.
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Pay fees by credit card.
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Update or change your credit card information.
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Access online video sessions.
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When you become a client you will receive access to the portal.
Records Requests
If you need any of your confidential records released to a health care provider or other entity we will only do so with a detailed and signed Release of Information form. We may already have this but if you have any doubts fill out and sign a new form. You may electronically "sign" the form but to maintain confidentiality we will need to verify with you by telephone. Insurance companies will automatically receive only the information required for billing and reimbursement.
Your records can be released to you or to the organization(s) you specify. They will not be released to anyone not named in your Release of Information. There may be a small fee to cover photocopying expenses.
Forms
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All of these forms can be downloaded and saved, filled out, and securely sent back to us via the web portal. Return them before your first appointment so you and Etta can better use your time together. If you prefer you can print them, fill them out by hand, and mail, fax, or bring them with you.
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Your informed consent for treatment must be signed before we can get to work, your payment agreement ensures we all agree to the "business" aspects, and the questionnaire allows Etta to review some information that will save you time at your first appointment.
Client Information & Payment Agreement
This is for basic information about, insurance, billing, contacts, and personal preferences.
Client Consent
to Treat
This is the agreement between you and Etta on the therapy you are seeking.
Client Intake Questionnaire
This is initial information that helps Etta form ideas about treatment to discuss with you.
These are items about your privacy rights, health insurance, and release of information for you to download and use.
Release of Information
This details with whom and under what circumstances your private information may be shared.
Questions for Your Insurance Provider
This is suggested questions to help you get a better idea about what you insurance covers.
Your Privacy
This is a detailed explanation of your legal privacy rights.
Find Us
We are easy to find, 517 3rd Street, Suite 10, at the intersection of 3rd and F in Old Town Eureka.
