Practice Policies

APPOINTMENTS AND CANCELLATIONS

Please remember to cancel or reschedule 24 hours in advance. You will be responsible for a $25 fee if cancellation is less than 24 hours. The standard meeting time for therapy is 50 minutes. It is up to you, however, to determine the length of time of your sessions. Requests to change the 50-minute session needs to be discussed with the therapist in order for time to be scheduled in advance. Cancellations and re-scheduled sessions will be subject to charge if NOT RECEIVED AT LEAST 24 HOURS IN ADVANCE. This is necessary because a time commitment is made to you and is held exclusively for you. If you are late for a session, you may lose some of that session time.

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SOCIAL MEDIA AND TELECOMMUNICATION

Due to the importance of your confidentiality and the importance of minimizing dual relationships, I do not accept friend or contact requests from current or former clients on any of my personal social networking accounts (Facebook, LinkedIn, etc). I believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. I do maintain professional social media accounts that contain supplemental therapeutic content that you are welcome to explore at your own discretion. I do not disclose any confidential treatment information through social media, nor do I provide professional counseling services through social media. Please keep in mind that choosing to follow these accounts and engage with this content may compromise your confidentiality, and by doing so, you are acknowledging such risks. If you have questions about this, please bring them up when we meet and we can talk more about it.

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ELECTRONIC COMMUNICATION

I cannot ensure the confidentiality of any form of communication through electronic media, including text messages. If you prefer to communicate via email or text messaging for issues regarding scheduling or cancellations, it is at your own risk. While I may try to return messages in a timely manner, I cannot guarantee immediate response and request that you do not use these methods of communication to discuss therapeutic content and/or request assistance for emergencies.

Services by electronic means, including but not limited to telephone communication, the Internet, facsimile machines, and e-mail is considered telemedicine by the State of California. Under the California Telemedicine Act of 1996, telemedicine is broadly defined as the use of information technology to deliver medical services and information from one location to another. If you and your therapist chose to use information technology for some or all of your treatment, you need to understand that: (1) You retain the option to withhold or withdraw consent at any time without affecting the right to future care or treatment or risking the loss or withdrawal of any program benefits to which you would otherwise be entitled. (2) All existing confidentiality protections are equally applicable. (3) Your access to all medical information transmitted during a telemedicine consultation is guaranteed, and copies of this information are available for a reasonable fee. (4) Dissemination of any of your identifiable images or information from the telemedicine interaction to researchers or other entities shall not occur without your consent. (5) There are potential risks, consequences, and benefits of telemedicine. Potential benefits include, but are not limited to improved communication capabilities, providing convenient access to up-to-date information, consultations, support, reduced costs, improved quality, change in the conditions of practice, improved access to therapy, better continuity of care, and reduction of lost work time and travel costs. Effective therapy is often facilitated when the therapist gathers within a session or a series of sessions, a multitude of observations, information, and experiences about the client. Therapists may make clinical assessments, diagnosis, and interventions based not only on direct verbal or auditory communications, written reports, and third person consultations, but also from direct visual and olfactory observations, information, and experiences. When using information technology in therapy services, potential risks include, but are not limited to the therapist's inability to make visual and olfactory observations of clinically or therapeutically potentially relevant issues such as: your physical condition including deformities, apparent height and weight, body type, attractiveness relative to social and cultural norms or standards, gait and motor coordination, posture, work speed, any noteworthy mannerism or gestures, physical or medical conditions including bruises or injuries, basic grooming and hygiene including appropriateness of dress, eye contact (including any changes in the previously listed issues), sex, chronological and apparent age, ethnicity, facial and body language, and congruence of language and facial or bodily expression. Potential consequences thus include the therapist not being aware of what he or she would consider important information, that you may not recognize as significant to present verbally the therapist.

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PROFESSIONAL BOUNDARIES

If we live in the same community, it is likely that we may happen to see each other in public from time to time. Please keep in mind that I will not initiate contact with you if I see you in the community. This is to protect your confidentiality. You are welcome to approach me, say “hello”, or acknowledge me if you would like to, just know that by doing so it could compromise your confidentiality in some ways.

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MINORS

If you are a minor, your parents may be legally entitled to some information about your therapy. I will discuss with you and your parents what information is appropriate for them to receive and which issues are more appropriately kept confidential. I reserve the right to request legal documentation and information about custodial arrangements before continuing the treatment of any minor (persons under the age of 18). These requests may include, but are not limited to, court appointed custody arrangements, guardianship letters, restraining orders, and/or adoption paperwork.

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PATIENT LITIGATION

I will not voluntarily participate in any litigation or custody dispute in which my clients are a part of. I generally do not communicate with my client’s attorneys and will generally not write or sign letters, reports, declarations, or affidavits to be used in client’s legal matter. Should this provider or treatment records be subpoenaed, or ordered by a court of law, to appear as a witness, you agree to reimburse me for any time spent for preparation, travel, or other time in which I have made myself available for such an appearance at a rate of $300 per hour. Subpoena requests must be made at least 2 weeks in advance. All fees must be paid in full prior to the court appearance.

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THERAPIST-PATIENT PRIVILEGE

The information disclosed by clients (or patients), as well as any records created, is subject to therapist-patient privilege. The therapist-patient privilege results from the special relationship between “Therapist” and “Patient” in the eyes of the law. Typically, the client is the holder of the therapist-patient privilege. If therapist received a subpoena for records, deposition testimony, or testimony in a court of law, the therapist will assert the therapist-patient privilege on the client’s behalf until instructed, in writing, to do otherwise by client or client’s representative. Clients should be aware that they might be waiving the therapist-patient privilege if they make their mental or emotional state an issue in a legal proceeding. Clients should address any concerns they might have regarding the therapist-patient privilege with their attorney.

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SAFETY PLANNING

In the event that you are feeling unsafe or require immediate medical or psychiatric assistance, I will provide a safety assessment and ask you to voluntarily agree to a safety plan. If in my clinical opinion, you are a risk to yourself or others and you are unwilling to agree to a safety plan, I will legally and ethically follow mandated reporting procedures and contact the appropriate authorities. This could include, but is not limited to, contacting emergency contacts, contacting local authorities, contacting your primary care doctor, or Child Protective Services, etc. If over time, I decide that it is no longer ethically appropriate to continue treatment due to safety concerns, I will terminate the therapeutic relationship and provide a referral to a higher level or more appropriate level of care.

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FEE AGREEMENT

The usual and customary fee and/or insurance options will be discussed with you. You will be notified of any fee adjustment in advance. In addition, this fee may be adjusted by contract with insurance companies, managed care organizations, or other third-party payers, or through an agreement between us. From time-to-time, I may engage in telephone contact with third parties at your request and advance written authorization. You are responsible for payment of the agreed upon fee (on a pro rata basis) for any telephone calls lasting longer than fifteen minutes. Clients are expected to pay for services at the time services are rendered. Cash, major credit cards, and FSA/HSA cards are accepted. For billing purposes, we require that a credit card remain on file for you and we reserve the right to charge your credit card for late-cancelled or missed appointments (please refer to the above cancellation policy).

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GOOD FAITH ESTIMATE & NO SURPRISES ACT

Under the law, health care providers need to give clients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including therapy services. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including therapy services. You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service, or at any time during treatment. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, or how to dispute a bill, see your Estimate, or visit www.cms.gov/nosurprises.

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INSURANCE

Clients are responsible for any and all fees not reimbursed by their insurance company, managed care organization, or any other third-party payer. You are responsible for verifying and understanding the limits of your coverage, as well as your co-payments and deductibles. I am not a contracted provider with every insurance company or managed care organization. Should a client choose to use insurance, client will be provided with a statement which can be submitted to the third-party of their choice to seek reimbursement of fees already paid.

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LETTER WRITING

Treatment summary letters or other such evaluation notes may be requested as needed. Please be aware that requests must be made at least 2 weeks in advance, and the fee for each letter is $75.00. Please speak with me for further information or questions. At this time, I cannot provide clients with letters regarding emotional support animals (ESA), as this is out of my scope of practice. Please speak with me about this in during our session if you have any questions.

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PROVIDER AVAILABILITY

Please keep in mind that my availability is limited to day time office hours, Tuesday through Friday and often times I am unable to answer the phone due to meeting with clients. You are allowed to leave a confidential voice message at any time. I will make every effort to return calls within 24 hours (or by the next business day) but cannot guarantee the calls will be returned immediately. I am unable to provide 24-hour crisis services. In the event that you are feeling unsafe or require immediate medical or psychiatric assistance, please call 911, or go to the nearest emergency room.

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TERMINATION AND CONTINUATION OF CARE

Ending relationships can be difficult. Therefore, it is important to have a termination process in order to achieve some closure. The appropriate length of the termination depends on the length and intensity of the treatment. I may terminate treatment after appropriate discussion with you if one of the following apply: the therapy is not being effectively used, there are safety concerns that require a higher level of care, the treatment issues are beyond the scope of my practice, or if you are in default on payment. I reserve the right to terminate treatment due to personal and professional reasons or any unforeseen circumstances that may arise. I will not terminate the therapeutic relationship without first discussing and exploring the reasons and purpose of terminating. If therapy is terminated for any reason or you request another therapist, I will provide you with a list of qualified therapists to treat you and local community resources. You may also choose someone on your own or from another referral source. In the event of my termination of practice, incapacitation, or untimely death, your records will be taken over and contact will be made by a qualified mental health professional whom I have selected.

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Should you fail to schedule an appointment for two consecutive weeks, unless other arrangements have been made in advance, for legal and ethical reasons, I must consider the professional relationship discontinued.