Pink Positive Psychology
Call Us Today: (586) 209-7092
Royal Oak, MI 48067

"I am The Way and The Truth

and The Life" John 14:6 ♥


Serve God by serving others.

Practice Summary

Pink Positive Psychology specializes in individual therapy for females 13+ and their families.

We take an individualized and humanistic eclectic treatment approach, choosing from a wide array of evidence-based techniques

tailored and customized to address the specific needs of each person.

Research shows the most important factor to clients improving in therapy is the therapeutic alliance,

thus, choose a clinician you feel most comfortable with.


Practice Specialization

Females / Women / Christian Counseling

Insurances accepted

Private Pay

Private pay sessions are $160.00 per 1-hour face-to-face session or per

1-hour phone session. Insurance does not pay for phone sessions.


Scheduling an Appointment is Easy!

*New Client Registration / Appointment Request Form - Required

This form is used to gather a basic client profile of client's contact information, insurance information, and

to briefly identify reason(s) client is seeking help in order to register client/schedule client.




Fill out form online

Click HERE to schedule an appointment.


Call (833) PINK-PSY to schedule an appointment.



E-mail Melissa Mendoza at to schedule an appointment.

Melissa has a HIPPA compliant e-mail to communicate for coordinating care but her personal e-mail is used for new client appointments.


*All Form(s) are HIPPA compliant and ENCRYPTED which means your information is safe and secure.


Contact Information

Pink Positive Psychology

1212 S. Washington

Royal Oak, MI 48067-3219

Ph: (833) PINK-PSY

Fax: (833) 233-3547


Items to bring

Drivers License / Insurance Card(s) / Credit Card / Forms


*Please fill out forms before session online or at office; hard copies of forms are on the front desk. Thank you!

Checking In Upon Arrival

There is no receptionist. Upon arrival make yourself comfortable in the waiting area and please text your clinician that you have arrived

i.e. “Jane D. here” and she will be with you at your scheduled appointment time.


Filling out forms

On-line: Click on Link and fill out forms on your phone or PC

Online-Forms only take 5-minutes each to fill out.


By Hand: Print & Fill Out At Home in Blue or Black Ink & Bring Forms to Session


In Person: Let Clinician Know You Will Arrive to Session Early To Fill Out Forms in Person (Forms will be on front desk).


Required forms

*Consent for Treatment/Office Policies/Procedures/Emergency Contact/HIPPA

This form explains our expectations of you as a client, your protections and rights as a client, and our fees. Please read and fill out client name, and emergency contact.


* Payment Authorization Form


This form serves as an authorization to input your credit card information into our secure system and charge it when a balance on your account exists.


*Required Forms


Useful Forms

Beck Depression Inventory-II


This is an assessment tool to assess the magnitude of client's level of Depression; form only takes 5-7 minutes to fill out you can fill out on your phone.


Beck Anxiety Inventory

This is an assessment tool to assess the magnitude of client's level of Anxiety; form only takes 5-7 minutes to fill out.


Release of Information Form


This form is required for releasing information wherein form is used to coordinate care with other professionals such as your Primary Care Physician; Psychiatrist; Lawyer, School Counselor; Probation Officer; ect.


Payment Processing

Payment processed/due in full at onset of session; you will receive a receipt.

Acceptable Payment methods

Credit card payments: Visa, Mastercard, Discover & American Express

Length of Sessions

I am aware my sessions are 53-minutes long wherein 10-minutes to the hour

we will have a few minutes to summarize. Intake sessions typically last an hour.



Regarding arriving to appointment(s), any scheduling matters please contact clinician via mobile/cell phone.

Emergency Procedures

Please note clinician(s) do not work on an emergency basis.

If an emergency situation arises, you should call 911 to go to the nearest hospital emergency room.


Staying Abreast of Insurance Policy/Policies

IMPORTANT: Your benefits may change at any time and it is ultimately the client's/responsible parties

responsibility to stay abreast of policy/benefit changes for services rendered. Please note some insurance

policies carve out mental health coverage to different insurance carriers and often policies can change at any

time since not all policies run on a calendar year thus is it imperative for benefit of client/responsible party

please act/plan accordingly to prepare so you are not unexpectedly incurring the cost of the services rendered

at the out of pocket private pay rate of $160 per session. Please be aware that any quote of insurance coverage provided by my

insurance carrier, and obtained on my behalf by Pink Positive Psychology, is an estimate of coverage, and that

PPP is not responsible for any errors in the information provided.


Pink Positive Psychology Verifying Insurance

Your clinician will inform you of your insurance verification policy benefits estimate

i.e. payment amount, co-pay, deductible, deductible is or is not applicable to mental health

once insurance verification is processed by our billing department.

The sooner the insurance information is provided the soon we can verify your insurance.

Client Insurance Verification: Helpful Information

NPI is an acronym for National Provider Identifier


Pink Positive Psychology's Group NPI / NPI 2: 1730617358


Melissa E. Mendoza, LMSW Individual NPI / NPI 1: 1326441064





Example Questions to Inquire with your Insurance Company


Re: Outpatient / Mental Health Benefits

Effective Date of Policy?

Is my clinician a billable provider for myself at Pink Positive Psychology? Yes or No

Do I have a deductible? Yes or No

How much is my deductible? $_____

How much is remaining on my deductible? $_____

Is the deductible applicable to Mental Health? Yes or No

Do I have a co-pay? Yes or No

Co-Pay Amount: $______

Do I need Authorizations? Yes or No

How many sessions are permitted per calendar year? _____

Any diagnoses that are not covered by my mental health benefits/my clinician?

If I have a deductible and I have to pay full amount for session how much is the

Intake Session?

53+ Minute Session?


Appointment Reminders

You may receive appointment reminders sent to you via text and or e-mail.

Pink Positive Psychology

Located inside The Center for Natural Healing

1212 S. Washington

Royal Oak, MI 48067-3219


Appointments Available

Day • Evening • Weekend

Copyright © 2020 Pink Positive Psychology. All Rights Reserved.