Frequently Asked Questions

[Say plainly whether the practice is open, closed, or waitlisted, and how someone gets on the list. Example: "Yes — I have a limited number of new-patient openings each month. The contact form is the fastest route, and I reply within two business days." Update this line whenever your availability changes, since it is the single most-read answer on the site.]

I would rather tell you honestly at the outset that another clinician is a better match than take on care I am not the right person to provide. If my practice isn't a fit, I'll say so and point you toward more appropriate options.

[Describe your intake screening step, if you have one: whether there is a brief phone or video consultation before scheduling, who conducts it, how long it lasts, and whether it is free. If you do not offer one, replace this with how patients should make the request in writing instead.]

[List the populations and diagnoses you actually accept — e.g. "adults 18 and older, with a focus on treatment-resistant mood disorders" — and name anything you explicitly do not treat, such as active substance-use detoxification, eating disorders requiring medical monitoring, or forensic evaluations. Nothing in your CV establishes a clinical scope of practice, so this must come from you.]

[Give the practice location(s) and every state in which you hold an active, unrestricted medical license, since you may only treat patients physically located in those states. Example: "In-person visits are at [address]; telehealth is available to patients located in California at the time of the visit."]

A list of your current medications and doses — or the bottles themselves — plus the names of any psychiatric medications you have tried before and how each one went. Recent lab work, imaging, and notes from previous treating clinicians are all useful. If you have had prior brain-stimulation treatment, bring whatever documentation you have of the protocol and how you responded.

Don't worry if you can't assemble all of it. With your written consent, I can request records on your behalf.

[State your billing model exactly. If you are out-of-network, say so and explain the superbill process and that reimbursement depends on the patient's plan — do not promise a reimbursement percentage. If you are in-network, list the specific plans and note that patients should verify coverage with their insurer before the first visit.]

Full details are on the Fees & Access page.

[Fees for the initial evaluation and for follow-up visits, with session lengths, plus any charges for letters, forms, prior authorizations, or between-visit calls. Every fee on this site must match what your billing actually charges.]

Under the No Surprises Act, patients who are uninsured or not using insurance are entitled to a Good Faith Estimate of expected costs before care begins. [Confirm with your billing or compliance counsel how your practice issues this estimate, then describe that process here.]

[Your notice window, the amount charged for a late cancellation or no-show, whether insurance ever covers it (it generally does not), and any exceptions you make. Patients should be able to read this before they book, not after they miss a visit.]

[Only answer this if you offer interventional treatment clinically. If so, explain how device-based treatments are billed — per-session charges, course-of-treatment estimates, prior-authorization requirements, and what happens if an insurer denies coverage partway through a course. If you do not offer these treatments clinically, delete this question.]

[Confirm whether you offer video visits, which states patients may be located in, whether an initial evaluation can be done virtually, and whether any part of care requires an in-person visit. If you prescribe controlled substances, verify the current DEA telemedicine requirements with compliance counsel before publishing anything here — the rules have changed repeatedly.]

[Name the channel for non-urgent messages (portal, phone, or email), your expected response time, what happens after hours and on weekends, who covers when you are away, and whether between-visit clinical time is billed.]

Please do not use email or the contact form for anything urgent. Neither is monitored continuously.

This practice is not equipped to respond to emergencies, and this website is not monitored in real time. If you are in crisis, call or text 988 (Suicide & Crisis Lifeline), call 911, or go to your nearest emergency department.

If you are worried about someone else and they are in immediate danger, call 911 rather than waiting for a return message.

Visit frequency follows what the treatment requires rather than a fixed schedule. Periods of active medication change need closer follow-up; stable maintenance care needs less.

[Give your typical intervals for early treatment and for maintenance, and say whether you take on weekly psychotherapy patients. If — and only if — you deliver a device-based treatment clinically, add its cadence here too, since a course of stimulation runs far more frequently than ordinary follow-up; if you do not, leave it out rather than describing it in general terms. These cadences differ substantially between practices, so state yours rather than a generic range.]

No. Medication is one option among several, and a fair number of evaluations conclude with a recommendation for psychotherapy, attention to sleep, or further medical workup instead of — or before — a prescription. When I do recommend a medication, you will hear the reasoning, the alternatives I considered, the side effects worth watching for, and when we will reassess whether it is working.

[State your policy plainly: whether you prescribe controlled substances at all, which classes, whether you will do so at a first visit or in telehealth-only care, your requirements around prescription-monitoring database checks and visit frequency, and how refills are handled. Ambiguity here generates a great deal of avoidable phone traffic.]

Yes. What you share is protected health information under HIPAA and is not disclosed without your written authorization, apart from a narrow set of legal exceptions — imminent risk of serious harm to yourself or someone else, certain court orders, and mandated reporting of abuse of a child, elder, or dependent adult.

The full description of how your information is used and your rights over it is in the HIPAA Notice of Privacy Practices.

Gladly, with your written consent. Coordination matters more than usual in this kind of work: interventional and medication decisions depend on an accurate picture of what has already been tried, and the clinicians who know you best are usually the ones holding that history. I treat collaboration as part of the job rather than an extra.

Any records generated in the course of your care — including imaging or treatment records, if your care involves them — are part of your medical record and are handled under the same HIPAA protections as everything else in your chart. Research data are governed separately, under the consent form for the specific study, and participating in research is never a condition of receiving clinical care.

[If your clinical practice sends patients to a specific imaging facility, or uses a neuronavigation vendor or any third-party data processor, name each one here and confirm a business associate agreement is in place. If your practice generates no imaging or device data at all, say that instead — it is a simpler and more reassuring answer, and it is the honest one unless you are delivering imaging-guided treatment clinically.]

Transcranial magnetic stimulation uses a magnetic field delivered through a coil at the scalp to noninvasively modulate activity in the brain region beneath it. It is delivered while you are awake, without anesthesia and without surgery.

The guided part concerns where the coil goes. Instead of placing the coil by a scalp measurement that assumes every brain is arranged the same way, connectivity-guided targeting uses that individual's own functional MRI — a map of which regions' activity fluctuates together — to choose the stimulation site for that person. This is the approach behind the fMRI connectivity-guided TMS trial for chronic tinnitus I work on at Stanford, described on the Research page.

TMS itself is an established treatment and is FDA-cleared for several psychiatric indications. Chronic tinnitus is not one of them, and the individualized connectivity-guided targeting described above is being studied under a research protocol rather than delivered as routine care. What is available to you as clinical treatment is a separate question — see Am I a candidate for an interventional treatment? below.

The energy and the reach differ. TMS uses magnetic pulses and directly modulates only cortex near the surface of the brain, reaching deeper structures indirectly through the networks connected to that surface site. Low-intensity focused ultrasound (LIFU) uses sound waves that pass through the skull and converge on a small focal volume, which allows deep targets that TMS cannot reach directly to be stimulated without an incision and without implanting anything.

Low-intensity focused ultrasound for neuromodulation is distinct from the high-intensity focused ultrasound used to create lesions in some neurological conditions — the low-intensity form is intended to modulate activity, not destroy tissue. My work with LIFU is as a sub-investigator on a UCSF clinical trial in treatment-resistant depression. It is investigational for psychiatric use: it is not FDA-approved for any psychiatric indication, and it is available only to people who are screened for and enroll in a study.

Kilohertz transcranial magnetic perturbation is a newer class of noninvasive electromagnetic brain stimulation. I am a sub-investigator on an NIMH-funded study evaluating it for the anhedonic dimension of major depression — the loss of interest and pleasure that often persists after other symptoms improve. kTMP is investigational: it is not cleared or approved by the FDA for any indication, it exists only inside research protocols, and it is not a treatment that can be prescribed.

That question can only be answered by an evaluation, not by a website. Candidacy for any device-based treatment depends on your diagnosis, what you have already tried and at what doses, other medical conditions, current medications, and specific safety considerations — for TMS, for example, seizure risk and any ferromagnetic implants near the head.

[Critical: state which interventional treatments, if any, you offer to patients clinically as opposed to in research. Your CV establishes TMS, LIFU, and kTMP as research activities only. If you provide any of them clinically, list them here with the settings in which they are delivered; if you instead refer patients elsewhere for them, say that plainly so no one arrives expecting a treatment you do not provide.]

My current studies include fMRI connectivity-guided TMS for chronic tinnitus at Stanford, low-intensity focused ultrasound for treatment-resistant depression at UCSF, and kTMP for anhedonic depression. Each has its own eligibility criteria, its own study team, and its own institutional review board approval. Taking part in any of them means going through that study's IRB-approved screening and informed-consent process at the institution running it — not through this website, and not as part of a clinical visit.

[Say how someone actually reaches each open study, and what part — if any — your practice plays in it: the study coordinator's name and contact, a screening line or form, or the ClinicalTrials.gov identifier for each trial. If enquiries should not come to your practice at all, say that plainly instead; if you do pass names along, say so and say what you do with them. Confirm with each study team and IRB what recruitment language you are permitted to publish on a personal website before posting any of it — recruitment materials normally require IRB approval, and a practice site that appears to funnel patients into your own trials raises a conflict-of-interest question you should get ahead of.]

No. Clinical care and research participation are separate. Enrolling in a study is voluntary, requires its own informed consent, and is never a condition of being treated. Declining to participate — or withdrawing after you have enrolled — does not affect the care you receive.