All individual appointments are 50 minutes long.  A first couples appointment is 110 minutes long.

Depending on your concern, a physical exam might be helpful.   The most common reason I would recommend a physical exam is for sexual pain.  In that case a pelvic exam is needed to provide a diagnosis and recommend treatment.  Need for a physical exam is otherwise determined on a case by case basis with your input of course.

First of all, I am sorry that you may have had bad experiences in the past.  You deserve better.

Vulvovaginal exams are generally set up more for the comfort and ease of the provider rather than the client.  This leads to discomfort, fear, dread and at times traumatic experiences.

In my practice, I offer a feminist, trauma-sensitive exam.  First and foremost this means that you are in charge and that your experience is my primary concern.  This means we will take time before the exam to explore your past experiences and adjust our plan to offer you whatever support is needed.  This means taking the exam slowly and checking in frequently along the way.  It also means we can leave extra time at the end of the exam to support you in regulating your nervous system and coming out of the experience.

On a practical level, all exams are performed on a soft massage table.  I do not use stirrups for any exam.  The table is covered with cloth sheets, no crinkly paper is used.  You will be asked to undress from the waist down only and can cover yourself with a sheet.  I do not use uncomfortable gowns that leave you feeling exposed. 

If you have any special needs for your exam, please feel free to contact me to discuss before hand.

Yes, I perform vulvovaginal exams and pap smears for folks who have a history of pain or trauma with medical exams.  I have advanced training and experience in helping folks with a wide range of trauma that affects sexuality and bring this to bear as needed for the vulvovaginal exam.  This includes primarily slowing down and offering space for you to take ownership of the experience where possible.  Please see above for more details on the feminist, trauma-sensitive exam.

Yes, I am licensed to prescribe medications for folks living in New York or Vermont.

Yes, I can order labs and radiology studies for clients who live in New York and Vermont.  In most cases, labs and radiology studies are covered by insurance.  However, I cannot guarantee this coverage.  In the event that I recommend labs that are definitely not covered I will review this cost with you before hand.  

No.  As a counselor and coach I do not engage in sexual touch with clients at anytime.  

Yes, I see clients in person in my office in lovely downtown, Ithaca, NY.  I see clients via telehealth from anywhere in the world! 

To schedule a first appointment, please book a free consult so that we can take 10 minutes or so to see if working together would be a good fit. 

After your consult call, you will be invited to the client portal where you can schedule and change appointments as needed.

Confidentiality is essential to my practice.  I follow all federal regulations as outlined in the Health Insurance Portability and Accountability Act (HIPAA) to ensure your privacy is maintained at all times.

To ensure confidentiality, I ask that all communications outside of our appointments take place in the client portal as it is fully HIPAA compliant.

Of course, each situation is unique. Clients looking for support with menopause often only need a couple of visits to address their symptoms. Similarly, clients needing strictly medical support for a problem may only need a couple of visits. I often work with clients for sex counseling for 3- 6 months.  

Please fill out your intake form before your appointment. This form is easily filled out online and provides me with great information that I can review before you arrive.

Beyond that, I encourage you to build in a small buffer around the appointment if possible.  Take 10-15 minutes (or more if you can spare it) to slow down and begin to let your mind/body settle some.  Maybe take some time to follow your breath and let your experience turn inward a bit, allowing yourself to let go of your daily cares and worries; they will be there for you to pick back up later. Just notice how you are feeling and take a little time to take care of yourself.  Drink a big glass of water, shake off extra energy.  After the appointment, take a few minutes to let what we discussed settle and integrate before heading back into life.  Give yourself a few minutes to see what you need--a big glass of water, a stretch, to journal? 

You can access the client portal, here.

You can reset your password, here.

My fees vary based on the work we are doing together.  As an example, I charge $175 an hour for individual counseling/coaching and $180 an hour for couples counseling/coaching.  I charge $350 for initial medical consultations - including menopause, pain with sex, and other concerns requiring detailed medical evaluation. Please reach out to learn more about my fees and to see if working together is a good fit.  

I do not participate with any insurance companies. In some select circumstances, I will be able to give you a superbill which you can submit to your insurance company for out of network benefits.  

I do not offer a sliding scale at this time.

If cost is a barrier for you to work with me, please contact me to discuss further. 

Payment is due at the end of your appointment.  I accept cash, check or credit card.

In my experience, clients almost always have a great reason when they need to miss an appointment or reschedule. My only request is that you let me know as soon as possible if you need to make a schedule change.

In the unusual circumstance where appointments are missed and I am not notified beforehand, I will charge the full appointment fee.

I am licensed as a nurse practitioner in New York and Vermont.  I can provide diagnosis and treatment, including performing a physical exam, ordering labs, ordering radiology, and writing prescriptions for clients in these states. 

I can provide counseling or coaching to clients to folks outside of NY and VT.

Yes, I offer sex coaching one the same fee schedule above. The only difference is that I will not be able to offer a physical exam, labs or imaging, diagnosis, or prescriptions for medications. I can offer coaching that can help you work directly with a licensed medical professional in your state when needed.  

Superbills are only provided when I am working with you to treat a medical concern.  I cannot see clients for medical concerns outside of New York or Vermont, so I cannot offer superbills for any counseling/coaching done with clients living outside NY or VT.