Associates in Psychotherapy & Family Counseling
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    • Matthew S. Zilboorg MACP, LADC, MAC

Philip Pezeshki, MPA, MS, LCMHC, LADC

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E-mail Philip
(802) 658-4208, x114
Welcome!  And, congratulations on your willingness to move forward with changing your situation!

Please consult my Psychology Today Profile for more information about me.

https://squareup.com/appointments/book/9e918wdn8hcwmr/L1MYXYZWR4QNE/start​

Please find below the forms I prefer that you complete before your first session, if possible.  If it's convenient for you, please download and fill them out on your computer and email them back to me; otherwise, you can complete them on paper when you get to my office.  Please read over the last couple of forms, which you can sign at your first appointment.
Registration
File Size: 23 kb
File Type: docx
Download File

Mental health and addiction history
File Size: 26 kb
File Type: docx
Download File

Family history
File Size: 27 kb
File Type: docx
Download File

Professional Policies
File Size: 20 kb
File Type: docx
Download File

Disclosure Statement
File Size: 18 kb
File Type: docx
Download File

VT Statutes and HIPPA Notice
File Size: 89 kb
File Type: docx
Download File

Payment Options
I accept most insurances, including Medicaid.  If I do not presently accept your insurance, I would be happy to contact them about "single case" reimbursement, or work with you to find an amount on a sliding scale that is affordable to you.

Please let me know if you have any questions or concerns, and some good days/ti
mes for you to meet with me.

Thanks!
Philip

Philip Pezeshki, LCMHC, LADC (he/him/his)
d/b/a  A Calm Connection
#Associates in Psychotherapy and Family Counseling
(802) 658-2234 (fax)
(802) 658-4208, x114 (VM)
email: acalmconnection@gmail.com

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  • Home
  • About
  • Associates
    • Matthew S. Zilboorg MACP, LADC, MAC