The Institute of Shamanic Healing
Classes / Events
Fees, Insurance, and Payments
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Fees and Payment Options for Sessions
The fee for the individual session with Dr. Selena is currently 160.
We recognize the pressure of feeling the need for healing, while simultaneously being concerned about finances. We will do all that we can to insure that you get the healing that you need without straining your budget. Towards that end there are several options available to you. Please select from the options below.
How would you like to pay for sessions?
Health Insurance (we file for you)
I'm planning to file my own insurance claims
I would like to apply for Sliding Scale (reduced fee)
If you're planning to use Health Insurance or wish to apply for the Sliding Scale, please complete the appropriate sections below.
If you would prefer to file your own insurance claims, we will provide the information that you need after receipt of payment at the time of the session.
If you're planning to use health insurance and you would like for us to file the claims, please complete the information below.
Additionally, please send a picture of your insurance card to Selena@RestoreTheSoul.com.
Name of Insurance Plan
Your Date of Birth
Provider / Claims Phone Number
Insurance Claims Address
Primary Policy Holder Name
Primary Policy Holder's Date of Birth
Policy or ID Number
Application for Sliding Scale
The discount of fees is based on the total (gross) income for all members of your household. Before applying, please note:
If your total household income is more than 70,000 per year or 6,271 per month, you do not qualify for sliding scale discount and you will need to select another option from above.
How many wage earners are in your household?
3 or more
What is your total (gross) income for all wage earners in your household?
$0 - $20,000
$20,001 - $30,000
$30,001 - $40,000
$40,001 - $50,000
$60,001 - $69,999
$70,000 or more
In order to qualify for Sliding Scale Rates, please send a copy of a paycheck, W-2, or tax return for all wage earners in your household to Selena@RestoreTheSoul.com.
Forms of Payment for Sessions
Payment for services is due at the time services are provided. If you're planning to use insurance and we are filing on your behalf, only your portion of the fee will be due at the time services are provided.
Payment may be made by:
Credit Card through PayPal
Electronic Transfer from your Bank
Long Distance Clients - please use PayPal or Electronic Transfer for payments.
Electronic Payments (either directly through your bank or through PayPal) - please use the email address Selena@RestoreTheSoul.com to make the payment
Restore the Soul LLC
Selena Whittle, MS, LPC
455 G Avenue, Lake Oswego, OR 97034
Based in Oregon, Accepts Phone Clients Nationally and Internationally, Accepts Insurance in Oregon
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