You are entitled to receive a Good Faith Estimate explaining the cost of your therapy. While it is not possible for a therapist to know in advance how many psychotherapy appointments may be necessary or appropriate for a given person, this form provides an estimated cost of services provided. Your total cost of services will depend upon the number of psychotherapy sessions you attend, your individual circumstances, and the type and amount of services that are provided to you. This estimate is not a contract and does not obligate you to obtain services from the provider listed, nor does it include any services rendered to you that are not identified here. The estimate is based on information known at the time the estimate was created.