As a result of the No Surprises Act, a Good Faith Estimate (GFE) agreement form will be sent for your review following the determination of needs. This will include an estimate of the cost you will pay over the course of your clinical services, which will be based on the estimate of services needed, duration, and potential diagnoses. Under the law, these estimates must be provided to patients who don’t have insurance or who are not using insurance to cover costs of their treatment. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises