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Terms and Policy

Practice and Privacy Policies
Welcome to my practice. Please read this carefully and save it as it will form the contract between us regarding your treatment. You will be asked to sign a this consent that I will keep in your chart stating you have read and agreed to these practice policies.

Commitment to Treatment:
Psychotherapy varies depending on the presenting problems and the interactions of the client and therapist. It is unlike other medical treatments in that it requires an active effort on your part in order to be successful. It often leads to improved moods and relationships but you may also experience emotions that are uncomfortable for you. It may require you to look at your history and life in ways that can feel difficult. The assessment process involves 1-2 sessions in which we clarify goals you would like to address in treatment. Therapy involves a commitment of time, energy and money so please bring up your questions and concerns as they arise. It is important to end your therapy in person rather than over the phone or email, as learning to end a relationship is an important life skill.

Individual sessions are 50 minutes in length. Please make an effort to be on time for your appointments. Arriving anytime after the scheduled session deducts time from your session.

Missed Appointments:
If you cannot keep your appointment, please give me atleast 24 hours notice (more is appreciated) so I can make the time available to others. If you cancel with less than 24 hours notice or you miss a scheduled appointment, you will be charged a fee of what your insurance company usually pays for a session.  If you are paying out of pocket the missed appointment fee is $75. Cancellations for Monday appointments need to made before Friday at 5pm to avoid the fee. Please note that insurance companies do not reimburse for missed sessions.

Contact and email outside of a session:
If you need to reach me, please leave a message on my voice mail. I try to return phone calls within the same day, with the exception of weekends, holidays, and vacations. If you have a mental health emergency, I encourage you to not wait for a call back. I do not always carry a phone nor am I available at all times. If you are unable to reach me, please call Ridgeview Institute at 770-434-4567 or Peachford Hospital at 770-455-3200. Call 911 or, go to your
nearest emergency room.

Both text messaging and emailing are not secure means of communication and may compromise your confidentiality. Email and text messaging are not be utilized for therapeutic concerns or emergencies, only for brief topics such as appointment confirmations.  Appointments can be scheduled by phone, email, or text. A reminder text will be sent 24 hours before your appointment.  This is a courtesy reminder.

Insurance Reimbursement and Financial Responsibility:
I am a provider for select private insurance plans. Please inquire about your benefits and coverage prior to the first session. Most plans now have a deductible amount that must be met before your the insurance will pay. These often start over as of the first of the year. If you have a deductible, I will collect the allowed amount insurance reimburses at each session and file the claim towards meeting your deductible. If you do not have a deductible or it's been met, you will pay a co-payment at our session. That amount varies depending on your plan's policy.

If you chose to utilize insurance, I will be releasing your insurance and demographic information to the billing company, Champ Ventures. I have contracted with Champ Ventures to submit my billing to insurance companies and conduct collections. If you do not have insurance, my fee for individual counseling is $100 per session unless a sliding scale fee has been agreed upon.

Payment options for co-payments and fees include check, cash, and debit and credit cards as well as health saving cards. Payment is due at the time of service. Returned checks incur a $25 fee in addition to the check amount.

Confidentiality and Privacy Practices:
The rest of this document covers the privacy act passed by U.S. Congress. It's my obligation to clarify your rights and my policies.

General information that is part of your chart consists of the initial paperwork that you fill out, billing and insurance records, written reports from other providers and reports I write. These documents may be released with your signature. Notes that I write during our sessions are not part of this record and I do not release them. These notes belong to me and you may see them but not have a copy of them. The information that you share with me is confidential
except for the following situations. If I believe a child or an elderly person is being abused, I must report this. If I believe that you are a danger to yourself or others, I must take appropriate actions. At times I will consult with other professionals about my clients as a part of improving my skills. If you initiate an inquiry with the licensing board, I may be required to disclose information about you.

You have the following rights: to request copies of the general record, to request the withholding of certain information, to ask that changes be made to the record, to be notified of any releases of information and to request that bills and correspondence be sent to a confidential address. If you feel privacy rights are violated, please speak with me about this.
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