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The Boris Lawrence Henson Foundation
Break the Silence Break the Cycle
Home
About
Letter From Our Founder
Leadership Team
Contact Us
Blog
Resource Guide
Programs & Services
African American Cultural Competency Training
Mental Wellness Support Program
Women’s Mental Wellness Client Survey
Release Trauma Client Survey
150 Black Men Client Quality of Service Survey
Provider Service Completion Survey
Provider Service Availability and Agreement
The Unspoken Curriculum
Scholarship Fund
Ways to Give
Give Monthly – Make Joy Revolutionary
Give Change – Connect a card to round-up your purchases to the next dollar and donate your change!
Donate
Search:
Home
About
Letter From Our Founder
Leadership Team
Contact Us
Blog
Resource Guide
Programs & Services
African American Cultural Competency Training
Mental Wellness Support Program
Women’s Mental Wellness Client Survey
Release Trauma Client Survey
150 Black Men Client Quality of Service Survey
Provider Service Completion Survey
Provider Service Availability and Agreement
The Unspoken Curriculum
Scholarship Fund
Ways to Give
Give Monthly – Make Joy Revolutionary
Give Change – Connect a card to round-up your purchases to the next dollar and donate your change!
Donate
Teen and Young Adult Support Group – Provider Invoice Portal
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Service Provider
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First
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Group Session
Group Name
*
Approved Group Number
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Group Session Date / Time
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Date
Time
Individual invoices per group session.
Name(s) of All Group Attendees
*
Visit CPT Code
*
90853: Group psychotherapy
90849: Multiple-family group psychotherapy by physician directed
Other
Other CPT Code
Is this invoice for the final group session?
*
Yes
No
Comment or Message
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Billable Charge
*
Universal Flat Rate - $300.00
I accept the universal flat rate per session.
Payment Choice
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Direct Deposit (ACH Transfer) - 14 business day processing
*New* option to receive payment via credit card
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Routing Number
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The person submitting this invoice is the owner or an authorized agent.
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