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 thorough 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 $120 hr for a 60 mn session 

I do offer some sliding-scale fees. A typical sliding scale can be offered at the 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.

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

350 Maplewood 

Ambridge, PA 15003

Or use our contact form.


New client? I have a patient portal that allows you to do everything online. This means that we can start the first session without the burden of intake paperwork. 

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