Teen DBT Course Form | drnatashaparekh

Sign up for the Teen DBT Lite Skills Course

Age: 13-17. Interested families can fill out an interest form below and will be contacted to set up an intake assessment to determine fit for the course.

When: The intake can be scheduled any time prior to the start date of the course (TBD). The skills course will take place on Mondays 3:30-5pm, start date TBD (will coordinate meetings around holidays, as needed)

Where: This is an in-person course located at Novo Behavioral Health (3340 Republic Ave, Suite 110, St. Louis Park, MN 55426). Please look for the conference room entrance to the left of the main door.

Cost: The intake can be billed to insurance or be self-pay depending on client preference. The DBT Lite 12-week group skills course is not covered by insurance. Eligible participants will be asked to pay upfront for 4 sessions in the amount of $300 (1/3 of the course). Remaining sessions will be charged weekly at the rate of $75.

Check this box if client parent/guardians are divorced/separated and have joint or shared legal custody.

Please select if your child has any of the following:

OCD

ADHD

Active Psychosis

Are you involved with the legal system at this time?

Yes

I understand that the DBT skills course is self pay Required

Yes

I understand that if my teen is eligible for the skills course after intake, I will be responsible for paying $300 (1/3 of the course) upfront. Remaining skills course sessions will be charged weekly. Required

Yes

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