CONTACT FORM

Before contacting me, please review the following:
□ I understand that Miriam Rubino, LMFT does not accept insurance directly. Superbills may be available for clients seeking possible out-of-network reimbursement, and I am responsible for verifying my own benefits.
□ I understand that the full fee for a psychotherapy session is $250 for an Evaluation session and $200-225 per 50 min session depending on location.
□ I understand that submitting this form does not establish a therapist-client relationship.

□ Privacy note: Please do not include sensitive medical, mental health, trauma, diagnosis, or other confidential information in this form. This form is intended only for general inquiries and consultation requests and should not be used for emergencies or urgent mental health concerns.

If you are experiencing a mental health emergency, call 911 or 988, or go to your nearest emergency room.