This form can be used by mental health providers to full the required good faith estimates of expected charges. This requirement goes into effect in January 2022. A Good Faith Estimate must be provided within 3 business days. Information regarding services must be furnished within 1 business day of scheduling a service to be provided in 3 business days and within 3 business days of scheduling a service to be provided in at least 10 business days. We recommend using the Psychology Forms Filler to individualize this form for your practice. (2021, practice management, financial, forms)