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Complete Your Intake Forms Before Your Appointment
For your convenience, we offer printable intake forms if you prefer to complete your paperwork by hand before your scheduled evaluation. Simply download and fill out the forms below, then bring them with you to your first session. This helps us make the most of your appointment time and ensures a smooth, stress-free check-in process. Please let us know if you plan to print out the forms and bring them in with you, so your appointment does not get rescheduled.
Frequently Asked Questions
Here are some frequently asked questions to get you familiar with our therapeutic process.
What types of therapy do you use?
At Peaceful Healing Counseling Services, we use only evidence-based therapeutic approaches—methods that are proven through research to be effective in helping clients make lasting, meaningful change. Our clinicians tailor each treatment plan to your unique needs, ensuring your therapy experience is both personalized and grounded in science.
Some of the primary evidence-based therapies we offer include:
- Cognitive Behavioral Therapy (CBT): A structured, goal-oriented approach that helps identify and change unhelpful thought patterns and behaviors to improve mood, self-esteem, and daily functioning.
- Dialectical Behavior Therapy (DBT): Focuses on building skills in mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness—especially beneficial for managing strong emotions and relationships.
- Cognitive Processing Therapy (CPT): A specialized, evidence-based trauma treatment that helps individuals process and reframe unhelpful beliefs related to traumatic experiences, fostering healing and resilience.
- Person-Centered Therapy: A supportive, empathetic approach that fosters self-awareness and personal growth within a safe, judgment-free environment.
- Trauma-Informed Therapy: Emphasizes safety, empowerment, and understanding while addressing the impact of trauma using techniques supported by current research.
- Therapy-Based Play (for children): A developmentally appropriate, evidence-based approach that helps children express emotions, develop coping skills, and build confidence through play.
Every therapy session at Peaceful Healing Counseling Services is guided by proven methods, clinical expertise, and genuine compassion—so you or your child can experience true, lasting healing.
What should I expect at my first session?
Your first session at Peaceful Healing Counseling Services is all about creating comfort, connection, and understanding. We know that starting therapy can feel like a big step, so we take time to ensure you feel supported every step of the way.
For Adults:
During your initial session, your therapist will take time to learn about you—your background, what brings you to therapy, and what goals you hope to achieve. Together, you’ll begin identifying areas of focus and discuss what therapeutic approach may best meet your needs. It’s also a chance for you to ask questions and get a feel for how we work. Our goal is to build a foundation of trust and collaboration from the very start.
For Children and Teens:
The first session typically includes both the parent(s) or guardian(s) and the child for the first half, followed by time with the child alone for the second half. This structure allows the therapist to hear from both the family and the child, gain a full understanding of the situation, and begin building a sense of safety and rapport. Parents can share background information, while children have space to express themselves freely. If parents would like to meet with the therapist prior to the evaluation to discuss topics that they do not wish their child to hear, we are happy to schedule a free, 15-minute screening with the therapist.
We believe the first session sets the tone for the entire therapeutic relationship—one that’s built on empathy, respect, and teamwork. By the end of your session, you’ll have a clearer understanding of how therapy works, what to expect moving forward, and a personalized plan for your healing journey.
How much does therapy cost?
At Peaceful Healing Counseling Services, we value transparency in every aspect of the therapeutic process — including billing. Prior to beginning treatment, you will receive a detailed overview of your insurance benefits and an Insurance Estimate to help you understand any out-of-pocket costs associated with your sessions.
If you are paying privately (without using insurance), you will receive a Good Faith Estimate outlining the anticipated cost of services before your first appointment. Our goal is to ensure you feel fully informed and confident about the financial aspects of your care.
A Good Faith Estimate (GFE) is a written estimate of the costs you might expect for counseling or mental health services — especially when you are paying out-of-pocket (not using insurance). Under federal law (the No Surprises Act, effective January 1, 2022), health care providers must offer a Good Faith Estimate for non-emergency services if you either:
- Schedule services at least 3 business days in advance, or
- Ask for an estimate even before scheduling
- The estimate should include the expected costs for the service itself and any related services that are reasonably anticipated (for example, assessments, materials, extra time).
- If the final bill ends up being $400 or more above the estimate, you have the right to dispute the charges through a formal process.
The Good Faith Estimate is not a contract — it’s a helpful tool so you can make informed decisions before starting services.
If you are paying out-of-pocket (i.e. not using insurance), you have the right to request a Good Faith Estimate of expected costs before starting services. This estimate helps you understand what your fees may be, and if the final bill is $400 or more above the estimate, you may dispute the discrepancy. Even though the federal No Surprises Act protects many patients, Illinois law also prohibits unexpected “balance billing” when specific conditions apply.
If you believe you have been billed unfairly or incorrectly, you may contact the Illinois Department of Insurance or the federal No Surprises Helpdesk for assistance.
📞 No Surprises Help Desk
Phone: 1-800-985-3059
Hours: 8 a.m. – 8 p.m. Eastern Time, 7 days a week
Email: NoSurprises@cms.hhs.gov
Website: https://www.cms.gov/nosurprises
Please see our providers fee schedules below.
Jennifer Chicoine, M.A., LCPC, CCTP
Initial: $200.00
Ongoing: $175.00
Melissa Carrillo, M.A., LCPC, ADHD-CCSP
Initial: $200.00
Ongoing: $175.00
Elizabeth Farnesi-Mitchell, M.A., B.S.
Initial: $100.00
Ongoing: $100.00
What is your cancellation policy?
Here at Peaceful Healing Counseling Services, PLLC, we completely understand that life happens and you will need to cancel from time-to-time. However, out of respect for the staff and other clients, it is important to be prompt about canceling or rescheduling your sessions should you need to do so.
If you need to reschedule or cancel your appointment, please do so at least 24 hours before your scheduled time. If you cancel within 24 hours of your appointment time, you will be charged a $100.00 late cancellation fee. If you fail to call and miss your appointment (no call/no show), you will be charged a $125.00 no-show fee. These fees are non-negotiable.
If you cancel more than 2 consecutive times, then the therapist may remove you from their schedule until a better time and day can be determined that works for your schedule. We would like to accommodate you so that you can be consistent with your sessions. Therapy is most beneficial when it is consistent.
Peaceful Healing Counseling Services, PLLC reserves the right to modify, amend, or change its cancellation policy at any time, without prior notice or consent, at the discretion of the practice. Such changes shall be effective immediately upon posting or notification to clients.
Clients are encouraged to regularly review policy terms to ensure awareness of any modifications. By continuing to engage in services, clients agree to comply with the most current version of the cancellation policy. Should any questions arise, clients are advised to contact the practice for further clarification.
What can I do while my child is in their session?
For your convenience, we have a waiting room with magazines and relaxing music while you wait. You are also more than welcome to run an errand or go to the local coffee shop to grab a quick bite. If you choose to leave the facility while your child is in therapy, please note that you will need to be back by :45 to the hour so we can provide you with any updates from the session. If you are late to picking up your child (you arrive at the top of the next hour or later), you may be charged a late pick-up fee of $25.
What does Peaceful Healing do with my information?
The details you provide in the "New Client Paperwork", whether it be on a printed form or in the patient portal, is used to identify you, the patient, for billing purposes and for record-keeping purposes. Peaceful Healing, in its entirety, practices ethical recordkeeping in alignment with guidelines from the Health Insurance Portability and Accountability Act (HIPAA).
If I am experiencing an emergency, should I call my therapist?
If you are experiencing a mental health emergency or crisis, do not wait to contact your therapist. Our therapists do not provide emergency or crisis services and may not be immediately available.
If you are in danger or need immediate help, please use one of the following resources right away:
- Call 911 if you are in immediate danger or need urgent medical attention.
- Go to your nearest emergency room.
- Call or text 988 to reach the Suicide and Crisis Lifeline — available 24 hours a day, 7 days a week.
- You can also contact the Crisis Text Line by texting HOME to 741741, or call the CARES Hotline at 1-800-345-9049.
Once you are safe and stable, you can reach out to your therapist to discuss what happened and receive ongoing support. At Peaceful Healing Counseling Services, your safety and well-being are our top priority, and we want you to get the help you need right away in an emergency.
What are your privacy practices?
Your Privacy Matters to Us
Peaceful Healing Counseling Services, PLLC is committed to protecting your privacy and the confidentiality of your mental health information.
We follow all requirements of:
- The Health Insurance Portability and Accountability Act (HIPAA)
- Illinois mental health confidentiality laws, which provide additional protections for therapy records
How Your Information May Be Used
- We may use or share your information only when necessary for:
- Providing your treatment
- Receiving payment for services
- Practice operations (such as quality improvement or legal compliance)
- Situations required by law or related to safety concerns
- Any other use of your information requires your written permission.
Your Rights
You have the right to:
- Access your records
- Request corrections
- Ask for confidential communication methods
- Receive a copy of our full Notice of Privacy Practices
- File a complaint if you believe your privacy rights have been violated
Illinois-Specific Protections
Illinois law provides extra confidentiality protections for mental health records, including psychotherapy notes. These records are not released without your explicit consent, except when legally required.
Questions or Concerns?
If you have questions about your privacy rights or how your information is protected, please contact us:
Peaceful Healing Counseling Services, PLLC
15010 S. Ravinia Avenue, Suite 12
Orland Park, IL 60462
📞 708-971-0470
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights.
