Your First Session (Intake)


Prior to your first appointment, please download, read, and complete the forms below to the best of your ability. Please bring the completed forms along with a form of identification and copy of insurance card (if applicable) to your intake session. If you do not have access to a printer and/or do not have an opportunity to complete the forms prior to your session, please plan to arrive at the office 20-30 minutes before your session time to allow time to complete your paperwork.

To schedule an appointment at Northwest Relationships, please call us at: 253-292-1216 or contact us by email:

Your therapist will generally schedule 50- or 90-minute sessions with clients once per week at a time agreed on. If you arrive late for an appointment, you will only be able to meet with your therapist for the remaining time of the scheduled 50 minutes. Sometimes your therapist will meet more or less than once per week if that is consistent with a treatment plan you both agree to.

Services & fees

We now offer sliding fee services to clients without Health Insurance

At Northwest Relationships, we accept out-of-pocket payments along with some insurance plans for services. The insurance plans for which we are considered “in-network providers” are:

  • First Choice Health
  • Premera
  • Regence
  • United Behavioral Health (not including Apple Health)
  • Tricare (US Family Health Plan accepted)
  • Kaiser Permanente (PPO Plans)
  • Cigna


We are out-of-network for Aetna. We are happy to submit invoices directly for you if you have an out-of-network insurance plan, but fees for services will be collected at the time of your session. See the out-of-pocket/out-of-network rates below.

The out-of-pocket/out-of-network fees for sessions vary:

Therapy Sessions:

  • PhD rate:
    • Jennifer Sampson, PhD, LMFT, CST: $280/hour (intake), $250/hour (regular session);
    • Zain Shamoon, PhD, LMFTA: $150 (intake), $100 (regular session)
  • MS/LMFT rate: $185/hour (intake), $150 (regular session); or
  • MA/LMFTA rate: $125/hour (intake), $90/hour (regular session)
  • MFT Intern: Sliding fee scale, based on income ($20 intake; $20-60 regular session)


You will be expected to pay the full fee, or your full copayment/coinsurance amount if you are using insurance, at the time of each session unless we agree otherwise or unless you have insurance coverage that requires another arrangement. We accept payments by check, cash, or credit card. Payment schedules for other professional services will be agreed to when they are requested.