New Client Information

Scheduling an appointment:

Please, call Dr. Kukla at 847-701-4452 to discuss the possibility of working together and setting up an initial appointment. Due to my schedule, phone calls generally reach my voice mail initially. I make every effort to return your call the same day. If you are difficult to reach, please leave me some times you will be available. Most people provide their contact information and share a very brief description of the problems that are leading them to seek therapy. I provide a 15 to 20 minute free telephone consultation so that we can determine if I would be helpful for your needs.

Dr. Kukla offers day, evening, and weekend appointments. The first appointment is an initial assessment where a series of questions are discussed in an effort to clearly identify each individual or family’s concerns so that we can work together to develop goals that will shape our treatment focus. The first appointment is usually 50-60 minutes in length. Follow-up appointments are 45-50 minutes in length.

Preparing for your first appointment

New clients are asked to print out a registration packet under the “New Client Forms” section. This packet includes two documents for you to read: the Client Agreement and the Notification of Privacy Practices. It also contains two forms for you to print out, complete, and bring to our first meeting: the Signature Form and the Client Information Form. Completing this paperwork in advance will allow us to focus immediately on how I can provide help when we first meet.

Insurance, costs, and payment

Some clients opt against using insurance to maximally safeguard the confidentiality of treatment. I can provide more detailed information about the costs for self-pay and out-of-network clients upon request.

I am considered an in-network provider for the following insurance companies:

  • Medicare
  • APS
  • Cigna

I will submit the charges directly to these above insurance plans on your behalf as long as they directly provide your mental health care benefits. You would be responsible for your deductible and co-payments when we meet.

I am considered an out-of-network provider by all other insurance companies. You may contact your plan administrator to determine if you would be reimbursed for my services as part of your benefits.

Payment is expected at the time of service. Checks, cash, and credit/debit cards (Visa, MasterCard, and Discover) are accepted.

Dr. Kukla’s Good Faith Estimate:
Starting January 1, 2022, new legislation went into effect that requires health care providers and facilities to inform self-pay and uninsured individuals of their right to receive a “Good Faith Estimate” of expected charges. The purpose of the law, known as the “No Surprises Act”, is to protect self-pay/uninsured consumers from unanticipated and expensive bills for out-of-network services.

If you are uninsured or don’t plan to use your insurance:

  • You have the right to receive a Good Faith Estimate (GFE) explaining how much your treatment will cost.
  • You have the right to receive the GFE at least one (1) business day before your first scheduled appointment.
  • You have the right to dispute the bill if your costs are $400 or more over your GFE.
  • Be sure to save a copy or picture of your GFE for future reference.

For questions or more information about your right to a Good Faith Estimate, visit or call Dr. Kukla (847) 701-4452.

The No Surprises Act (NSA) applies specifically to those individuals who do not have insurance or who do not intend to use their insurance. If Dr. Kukla will bill your insurance or you plan to submit to insurance on your own, the right to receive a GFE does not apply to you. However, all psychotherapists already have an ethical obligation to provide advance notice of costs and fees for every patient.  If you are using insurance — either in network or out of network — it is long-standing Dr. Kukla policy to verify your benefits and to inform you before the first session of the expected out-of-pocket cost to you for your treatment. The NSA adds to these pre-existing practices by requiring further formal disclosures of anticipated fees specifically for self-pay and uninsured persons.

Please, download this form to get your Good Faith Estimate.