Forms & Fees

I have included the following forms for your convenience. There are some forms required by law, and others ensure that we have a thourough background without having to devote time in our first session to filling out the forms.  While it may seem like a substantial amount of paperwork, it is the foundation for our professional working partnership. You may also come early to your first appointment and fill these out in hard copy form. It is your choice. 



I offer a free one-time consultation over the phone to determine your needs and if therapy will be an appropriate approach.  

I charge $100 hr for a 60 mn session 

I do offer some sliding-scale fees. Typical sliding-scale can be offered at a lowest rate of $40 a session based on proof of need. 



I  participate with UPMC (except UPMC for YOU or UPMC For Life) Highmark Blue Cross Blue Shield, Cigna, Aetna and Health Advocate EAP. Prior to an appointment please call and verify your co-pay/ coinsurance and eligibility for services.  If you have another provider, there is some possibility to explore whether you can have services from an outside provider. Calling your insurance and asking about that option would be the first step. Many insurane companies are currently waiving cost-sharing so if you are concerned about your co-pay or deductible I encourage you to find out if that is currently waived by your insurance carrier. 

Note: You will need Adobe(r) Reader(r) to view PDF files. If you do not have it, you can download it for free.

Consent to Treatment Download
Open Office Writer [5.7 KB]
Client Confidential Information Form
Form-Confidential Info pt042014.docx
Microsoft Word document [16.0 KB]
Counseling Intake Form
Counseling Intake Form.pdf
Adobe Acrobat document [1.8 MB]


Maya  L. Andlig

421 Broad St 

Sewickley, PA 15143 


Phone: 412 749 -4949



Or use our contact form.


New client? Save time and reduce the amount of paperwork you have to fill out at your first visit. I provide them here for you to do at home. This background information will allow us to start working effectively together even in the first visit. 

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