Payments and Forms

Payments:

I accept PayPal and Venmo. To pay with PayPal, please fill out the following form. Upon selecting “Pay Now” you will be taken to PayPal to finish your transaction. 

For Venmo payments, you can find me under the username @CathyChambliss.

PayPal:

Cathy Chambliss, LMFT Session
Other Amount:
Your Name:

Cancellation Policy:

If you do not show up for your scheduled therapy appointment, and you have not notified me at least 24 hours in advance, you will be charged a Late Cancellation/No Show Fee of $220.

Forms:

Prior to your first session, please download and complete the New Client Intake Form and Telehealth Consent Form using Adobe Reader. Completed forms can be emailed to cathychambliss@aol.com. However, please note that emails are not encrypted and there is a risk of exposure. If you do not want to send your completed forms via email, please notify me.

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New Client Intake Form

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Informed Consent for In-Person Counseling Services During COVID-19 Pandemic

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Telehealth Consent Form

Contact Cathy Chambliss, LMFT

Ask a question or book an appointment below.

(310) 303-9132 (Call or Text)

PO Box 1070
Hermosa Beach, CA 90254

cathychambliss@aol.com