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General Information

  • I am committed to using my professional expertise helping you with whatever problems you bring to counseling or come up during sessions.

  • We will together establish your counseling/therapy goals and will clarify these from time to time.



  • Your appointment time is reserved for you and is scheduled according to your counseling/therapy needs and appointment availability. Standard appointments are approximately 45 to 55 minutes long.




  • When I am not in my office, I am available, with limitations, by telephone, text or e-mail. I can be reached at 617-259-8004 or at I will return calls as soon as possible, although I cannot guarantee how quickly I will be able to get back to you.


  • If you are experiencing a mental health emergency when you call and you do not reach me immediately, please go to the nearest hospital emergency room or call 988.



  • You will be charged $80 for a session you have failed to cancel within 48 hours of an appointment unless you cancel due to an unavoidable emergency. These fail-to-cancel visits are not billable to your insurance.




  • My fee is $200.00 for an evaluation and $160.00 per visit thereafter. All fees and co-payments are due at each session, cash or check, payable to Sara Silva, LICSW.


  • If you choose to use insurance, knowledge of your insurance coverage is your responsibility, but I will do what I can to help you determine the specific coverage your policy allows for outpatient mental health. In the event your insurance does not cover all or part of the visit, or benefits have been used for this calendar year, you will be responsible for all or part of the visit(s), including deductibles and co-payments as allowed by your insurance.


  • Some insurances require pre-authorization and some do not. Some require you to obtain an authorization number, others require me to fax a request for authorization. I recommend that you contact your insurance company to understand what is and is not covered, sessions authorized, and any deductibles or co-pays that apply.


  • I will submit claims for all insurance for which I am a network provider.  If I am not a network provider, you are expected to pay at the time of the visit and request reimbursement from your insurance company.




  •  During vacations, I will try to have my office covered by one of my colleagues, although that may not aways be possible.  In an emergency, always go to your nearest emergency room or call 988.



  • All information shared in this office is confidential unless a specific release of information is signed by you with the following exceptions:


  • You express your planned intention of harming yourself or another person. In that case, I am required by law to take action to protect you or the other person.


  • You share that you are severely neglecting or physically or sexually abusing a minor, or an elderly or disabled person who is in your care. In that case, I am required by law to report this abuse.


  • You are a minor and you share that you are being severely neglected or physically or sexually abused. I am required by law to report this abuse to ensure your safety


  • Your insurance company requests information relative to payment of your claim.


  • I have received a signed order by a judge to testify in court or to provide records.


  • Insurance companies require me to submit clinical information about you to authorize additional sessions.  Please let me know if you would like me to complete insurance forms together with you so you will know exactly what is being written/said about you

  • I participate in case consultation groups and may discuss your case in these groups in order to provide you the best possible care. I do my best to disguise identifying information.

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