Common use of Counseling Services Clause in Contracts

Counseling Services. Your first appointment (or more, in some cases) will involve an assessment of your needs. By the end of the assessment your counselor will be able to offer you some first impressions of what your work may include and recommendations for getting help. One of the recommendations may be psychotherapy. If so, ABO may or may not be able to provide you with psychotherapy, depending on your overall needs. If psychotherapy or any other recommendations suggested by your counselor include things that ABO cannot provide, you will be given suggestions of where you might receive those services. Wherever you choose to obtain treatment, you should evaluate the information from your initial assessment along with your own opinions of what sort of treatment you are willing to do and whether you feel comfortable working with the treating clinician. Therapy involves a large commitment of time, energy, and often money, so you should be very careful about the counselor you select. If you have questions about the procedures used or conclusions made by your counselor at ABO, please discuss them whenever they arise. If your doubts persist, your counselor will be happy to help you set up a meeting with another mental health professional for a second opinion. Psychotherapy is not easily described in general statements. It varies depending on the particular problems you are experiencing, the therapeutic methods used by your counselor, and the personalities of the counselor and client. There are many different methods counselors may use to deal with the problems that you hope to address. Psychotherapy is not like a medical doctor visit. Instead, it calls for a very active effort on your part. In order for the therapy to be most successful, you will have to work on things that are discussed both during your sessions and on your own. Psychotherapy can have benefits and risks. Since therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, shame, frustration, loneliness, and helplessness. The changes you make in therapy may also affect your relationships in unexpected ways. Psychotherapy has also been shown to have many benefits. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress. But there are no guarantees of what you will experience. MEETINGS The initial assessment will last from one to four sessions. During this time, you and your counselor can both decide if she/he is the best person to provide the services you need in order to meet your treatment goals. If you choose to begin psychotherapy, your counselor will usually schedule one meeting at a time you each agree on. Once an appointment is scheduled, you will be expected to attend unless you provide advance notice of cancellation. If you need to cancel an appointment, it is your responsibility to contact us to cancel. PROFESSIONAL FEES Fees will be collected when services are rendered.*In addition to therapy services fees may include assessment administration, scoring, and reporting; creating reports; creating copies of records on request; and consulting with other professionals at the client’s request. There will be an additional $25 fee assessed for any returned check. CHANGES AND CANCELLATIONS We understand that there are unforeseeable circumstances like sick children or bad weather. Your appointment is important though, and your therapist is happy to contact you for a phone session or a session via our HIPPA-compliant virtual therapy system so you don't need to leave your sick child or worry about traffic and weather. As long as you are in a confidential location, we can help you keep your regularly scheduled appointment. If you still must change or cancel your counseling appointment, please know: • Cancellations must be made during business hours. • Cancellations must be made within 48 hours of session time if using our online scheduling program. • We cannot accommodate cancellations made via email as we do not monitor email on a regular basis. • We may not accommodate cancellations made after hours or on holidays to our main number as we cannot check voice mail regularly. If you have an appointment on a Monday or the first day following a holiday, you must make your change or cancellation the last business day before your appointment. • Cancellations with less than 24 hours’ notice will result in a fee equal to the total amount of the missed session that will be collected at your next appointment, or, if payment information is on file, it will be debited from your credit card. • *After two no-shows/late cancellations, you will pre-pay a retainer before scheduling any future appointments. • Clients who have pre-paid agree to have the entire fee deducted from their pre-payment in cases of other no-shows and late changes/cancellations. COURT TESTIMONY • Court testimony costs begin at $250 per hour with a minimum charge of three hours. A retainer of $1000 is due one week prior to the court date. Travel is billed at .55/mile. Failure to provide the specific fees as described constitutes a release from the requested court appearance. • It is required that a minimum of 36 hours’ notice be given if the testimony is not required, otherwise the entire retainer may be forfeited. If proper notice is given, the retainer will be refunded. • Additional services related to court preparation including all correspondence with attorneys or other service providers via phone, email, or letter, documentation review and/or documentation preparation are also billed at $250 per hour, rounded to the nearest 15 minute increment. You (not your insurance company) are responsible for full payment of fees. It is very important that you find out exactly what mental health services your insurance policy covers. You must pay your xxxx first, then contact your insurance company regarding reimbursement. CONTACTING US We answer our main office number 9:00 AM – 5:00 PM Monday through Friday (except holidays). You may have your counselor’s cell phone number in order to coordinate administrative tasks (defined as appointment arrival, appointment time, and directions). Email, and text messaging are not secure mediums in terms of privacy and confidentiality so our policy regarding, electronic communication, and cell phone use includes the following: • We do not provide therapy/counseling via email or text messaging. • Text messaging and email will be used for administrative tasks only (as defined above). • Therapists may not acknowledge or return emails or text messages that are not administrative. This includes emergency texts and emails. • If your therapist leaves for an extended period of time you will be given the information for another licensed therapist with whom you may schedule if you need an appointment during your therapist’s absence. You may need to fill out other paperwork if therapist is in another practice.

Counseling Services. Your SUD therapy/counseling is a relationship between people that works in part because of clearly defined rights and responsibilities held by each person. As a client in the SUD counseling process, you have certain rights and responsibilities that are important for you to understand. There are also legal limitations to those rights that you should be aware of. I, as your SUD counselor, have corresponding responsibilities to you. These rights and responsibilities are described in the following sections. SUD therapy/counseling has both benefits and risks. Risks may include experiencing uncomfortable feelings, such as sadness, guilt, anxiety, anger, frustration, loneliness and helplessness, because the process of therapy often requires discussing the unpleasant aspects of your life. However, therapy has been shown to have benefits for individuals who undertake it. Therapy often leads to a significant reduction in feelings of distress, increased satisfaction in interpersonal relationships, greater personal awareness and insight, increased skills for managing stress and resolutions to specific problems. But, there are no guarantees about what will happen. Therapy requires a very active effort on your part. In order to be most successful, you will want to put into practice things we discuss outside of sessions. The first appointment (or more, in some cases) 2-3 sessions will involve an assessment a comprehensive evaluation of your needs. By the end of the assessment your counselor evaluation, I will be able to offer you some first initial impressions of what our work might include. At that point, we will discuss your work may include treatment goals and recommendations for getting helpcreate an initial treatment plan. One of the recommendations may be psychotherapy. If so, ABO may or may not be able to provide you with psychotherapy, depending on your overall needs. If psychotherapy or any other recommendations suggested by your counselor include things that ABO cannot provide, you will be given suggestions of where you might receive those services. Wherever you choose to obtain treatment, you You should evaluate the this information from your initial assessment along with and make your own opinions of what sort of treatment you are willing to do and assessment about whether you feel comfortable working with the treating clinician. Therapy involves a large commitment of time, energy, and often money, so you should be very careful about the counselor you selectme. If you have questions about the procedures used or conclusions made by your counselor at ABOmy procedures, please we should discuss them whenever they arise. If your doubts persist, your counselor I will be happy to help you set up a meeting with another mental health SUD professional for a second opinion. Psychotherapy PROFESSIONAL FEES The standard fee for a 50-minute individual session is not easily described in general statements. It varies depending on the particular problems you are experiencing, the therapeutic methods used by your counselor, $125.00 and the personalities of the counselor and client. There are many different methods counselors may use to deal with the problems that you hope to address. Psychotherapy is not like a medical doctor visit. Instead, it calls standard fee for a very active effort on your part. In order 90 minute couples session is $175.00 You are responsible for paying the therapy to be most successful, you will have to work on things that are discussed both during your sessions and on your own. Psychotherapy can have benefits and risks. Since therapy often involves discussing unpleasant aspects full amount at the time of your lifesession, you may experience uncomfortable feelings like sadnessunless prior arrangements have been made. Payment must be made by cash, guilt, anger, shame, frustration, loneliness, and helplessness. The changes you make in therapy may also affect your relationships in unexpected ways. Psychotherapy has also been shown to have many benefits. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress. But there are no guarantees of what you will experience. MEETINGS The initial assessment will last from one to four sessions. During this time, you and your counselor can both decide if she/he is the best person to provide the services you need in order to meet your treatment goalsor credit card. If you choose refuse to begin psychotherapypay your debt, your counselor I reserve the right to use an attorney or collection agency to secure payment. APPOINTMENTS Appointments will usually schedule one meeting ordinarily be 45-60 minutes in duration, once per week at a time you each we agree on, although some sessions may be more, or less frequent as needed. Once an The time scheduled for your appointment is scheduled, assigned to you will be expected to attend unless and you provide advance notice of cancellationalone. If you need to cancel an appointmentor reschedule a session, I ask that you provide me with 24-hours notice. If you miss a session without canceling, or cancel with less than 24-hour notice, my policy is to collect the full session fee of $125.00/individual or $175.00/couples. It is important to note that insurance companies do not provide reimbursement for cancelled sessions; thus, you will be responsible for 100% of the full rate. If it is possible, I will try to find another time to reschedule the appointment. In addition, you are responsible for coming to your responsibility session on time; if you are late, your appointment will still need to contact us end at the scheduled time. Finally, I have the right to cancelterminate treatment after 2 missed appointments or habitual tardiness. Thank you for understanding. To schedule, cancel or change and appointment you may call, text or email me. You can expect a response before the end of the business day. INSURANCE I am not a participating provider for any insurance plan. If you would like, I will supply you with a receipt of payment for services, which you can submit to your insurance company for reimbursement. Please note that not all insurance companies reimburse for out-of-network providers. PROFESSIONAL FEES Fees will be collected when RECORDS I am required to keep appropriate records of the SUD therapy/counseling services that I provide. Your records are rendered.*In addition to therapy services fees may include assessment administrationmaintained in a secured, scoringencrypted, HIPAA compliant web-based system. I keep brief records noting that you were here, your reasons for seeking SUD therapy/counseling, the goals and progress we set for treatment, your diagnosis, topics we discussed, your medical, social, and reporting; creating reports; creating treatment history, records I receive from other providers, copies of records on request; and consulting with other professionals at the client’s request. There will be an additional $25 fee assessed for any returned check. CHANGES AND CANCELLATIONS We understand that there are unforeseeable circumstances like sick children or bad weather. Your appointment is important thoughI send to others, and your therapist is happy billing records. Except in unusual circumstances that involve danger to contact yourself, you for have the right to a phone session copy of your file. Because these are professional records, they may be misinterpreted and / or upsetting to untrained readers. For this reason, I recommend that you initially review them with me, or have them forwarded to another mental health professional to discuss the contents. You also have the right to request that a session via our HIPPA-compliant virtual therapy system so you don't need to leave copy of your sick child or worry about traffic and weather. As long as you are in a confidential location, we can help you keep your regularly scheduled appointment. If you still must change or cancel your counseling appointment, please know: • Cancellations must file be made during business hours. • Cancellations must be made within 48 hours of session time if using our online scheduling program. • We cannot accommodate cancellations made via email as we do not monitor email on a regular basis. • We may not accommodate cancellations made after hours or on holidays available to our main number as we cannot check voice mail regularly. If you have an appointment on a Monday or the first day following a holiday, you must make your change or cancellation the last business day before your appointment. • Cancellations with less than 24 hours’ notice will result in a fee equal to the total amount of the missed session that will be collected any other health care provider at your next appointment, or, if payment information is on file, it will be debited from your credit card. • *After two no-shows/late cancellations, you will pre-pay a retainer before scheduling any future appointments. • Clients who have pre-paid agree to have the entire fee deducted from their pre-payment in cases of other no-shows and late changes/cancellations. COURT TESTIMONY • Court testimony costs begin at $250 per hour with a minimum charge of three hours. A retainer of $1000 is due one week prior to the court date. Travel is billed at .55/mile. Failure to provide the specific fees as described constitutes a release from the requested court appearance. • It is required that a minimum of 36 hours’ notice be given if the testimony is not required, otherwise the entire retainer may be forfeited. If proper notice is given, the retainer will be refunded. • Additional services related to court preparation including all correspondence with attorneys or other service providers via phone, email, or letter, documentation review and/or documentation preparation are also billed at $250 per hour, rounded to the nearest 15 minute increment. You (not your insurance company) are responsible for full payment of fees. It is very important that you find out exactly what mental health services your insurance policy covers. You must pay your xxxx first, then contact your insurance company regarding reimbursement. CONTACTING US We answer our main office number 9:00 AM – 5:00 PM Monday through Friday (except holidays). You may have your counselor’s cell phone number in order to coordinate administrative tasks (defined as appointment arrival, appointment time, and directions). Email, and text messaging are not secure mediums in terms of privacy and confidentiality so our policy regarding, electronic communication, and cell phone use includes the following: • We do not provide therapy/counseling via email or text messaging. • Text messaging and email will be used for administrative tasks only (as defined above). • Therapists may not acknowledge or return emails or text messages that are not administrative. This includes emergency texts and emails. • If your therapist leaves for an extended period of time you will be given the information for another licensed therapist with whom you may schedule if you need an appointment during your therapist’s absence. You may need to fill out other paperwork if therapist is in another practicewritten request.

Counseling Services. People choose to participate in counseling for a variety of reasons. For most, the purpose of counseling is to generally improve one’s overall quality of life by addressing issues of concern, such as anxiety, depression, marital difficulties, addiction, or grief. Individual experiences in counseling can be different, depending on factors such as the personalities of the client and therapist, the mode of counseling techniques that the therapist utilizes, the issue(s) being addressed, and the amount of effort that the client puts forth. Your first appointment (or more, in some cases) initial sessions with Encourage Counseling Services will involve an assessment evaluation of your needs. By the end of the assessment evaluation, your counselor therapist will be able to offer you some first impressions of what your work may will include and recommendations for getting helpa treatment plan to follow, if you decide to continue with therapy. One of the recommendations may be psychotherapy. If so, ABO may or may not be able to provide you with psychotherapy, depending on your overall needs. If psychotherapy or any other recommendations suggested by your counselor include things that ABO cannot provide, you will be given suggestions of where you might receive those services. Wherever you choose to obtain treatment, you You should evaluate the this information from your initial assessment along with your own opinions of what sort of treatment you are willing to do and whether you feel comfortable working with the treating clinicianus. Therapy involves a large commitment of time, energymoney, and often moneyenergy, so you should be very careful about the counselor therapist you select. If you have questions about the procedures used or conclusions made by your counselor at ABOour procedures, please you should discuss them with your therapist whenever they arise. If your doubts persistyou wish, your counselor we will be happy willingly provide you with referrals to help you set up a meeting with another other mental health professional professionals for a second opinion, as you always have the right to choose to continue to receive counseling services from us or to ask to be referred to someone else. Psychotherapy Following the assessment period, which is not easily described in general statementstypically one to two sessions, one 50-minute session will be scheduled per week. Sessions will occur at a time you and your therapist agree upon, although sessions may be scheduled more or less frequently according to your needs. It varies depending on the particular problems is important to note that if you are experiencinglate to your appointment, your session will still end at the therapeutic methods used by your counselor, and the personalities of the counselor and clientoriginally scheduled time. There are many different methods counselors may use to deal with the problems It should be noted that you hope to address. Psychotherapy is not like a medical doctor visit. Instead, it calls for a very active effort on your part. In order for the therapy to be most successful, you will have to work on things that are discussed both during your sessions and on your own. Psychotherapy can have benefits and benefits, as well as potential risks. Since therapy often oftentimes involves discussing unpleasant difficult aspects of your life, you may experience uncomfortable feelings like such as sadness, guilt, anger, shame, frustration, loneliness, and helplessness. The Making changes you make in your beliefs or behaviors can be anxiety provoking, and can be disruptive to your current relationships. However, therapy may also affect your relationships in unexpected ways. Psychotherapy has also been shown to have many benefits. Therapy For example, therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress. But Of course, every individual’s experience is different and there are no guarantees of what you will experience. MEETINGS The initial assessment It is important that you carefully consider whether these risks are worth the benefits to you of changing. Most people who take these risks find that therapy is helpful. Finally, the therapeutic relationship is ended after the last scheduled appointment, or when so stated by you or your therapist. As the client, you typically will last from be the one to four sessions. During this timewho decides when therapy will end, which usually occurs once you and your counselor can both decide if she/he is the best person to provide the services therapist agree that you need in order to meet have met your treatment goals. If you choose to begin psychotherapyHowever, your counselor will usually schedule one meeting at a time you each agree on. Once an appointment is scheduled, you will be expected to attend unless you provide advance notice of cancellation. If you need to cancel an appointment, it is your responsibility to contact us to cancel. PROFESSIONAL FEES Fees will be collected when services are rendered.*In addition to therapy services fees may include assessment administration, scoring, and reporting; creating reports; creating copies of records on request; and consulting with other professionals at the client’s request. There will be an additional $25 fee assessed for any returned check. CHANGES AND CANCELLATIONS We understand that there are unforeseeable circumstances like sick children or bad weathera few exceptions. Your appointment One such exception is important though, and if your therapist does not believe that he/she is happy professionally able to contact meet your needs. This could possibly be because your therapist does not believe that he/she holds the proper training and skills to help you, due to the type of presenting problem that you for have. In such a phone session or a session via our HIPPA-compliant virtual therapy system so situation your therapist will refer you don't need to leave your sick child or worry about traffic and weather. As long as you are in a confidential location, we can help you keep your regularly scheduled appointment. If you still must change or cancel another therapist who may be able to meet your counseling appointment, please know: • Cancellations must be made during business hours. • Cancellations must be made within 48 hours of session time if using our online scheduling program. • We cannot accommodate cancellations made via email as we do not monitor email on a regular basis. • We may not accommodate cancellations made after hours or on holidays to our main number as we cannot check voice mail regularly. If you have an appointment on a Monday or the first day following a holiday, you must make your change or cancellation the last business day before your appointment. • Cancellations with less than 24 hours’ notice will result in a fee equal to the total amount of the missed session that will be collected at your next appointment, or, if payment information is on file, it will be debited from your credit card. • *After two no-shows/late cancellations, you will pre-pay a retainer before scheduling any future appointments. • Clients who have pre-paid agree to have the entire fee deducted from their pre-payment in cases of other no-shows and late changes/cancellations. COURT TESTIMONY • Court testimony costs begin at $250 per hour with a minimum charge of three hours. A retainer of $1000 is due one week prior to the court date. Travel is billed at .55/mile. Failure to provide the specific fees as described constitutes a release from the requested court appearance. • It is required that a minimum of 36 hours’ notice be given if the testimony is not required, otherwise the entire retainer may be forfeited. If proper notice is given, the retainer will be refunded. • Additional services related to court preparation including all correspondence with attorneys or other service providers via phone, email, or letter, documentation review and/or documentation preparation are also billed at $250 per hour, rounded to the nearest 15 minute increment. You (not your insurance company) are responsible for full payment of fees. It is very important that you find out exactly what mental health services your insurance policy covers. You must pay your xxxx first, then contact your insurance company regarding reimbursement. CONTACTING US We answer our main office number 9:00 AM – 5:00 PM Monday through Friday (except holidays). You may have your counselor’s cell phone number in order to coordinate administrative tasks (defined as appointment arrival, appointment time, and directions). Email, and text messaging are not secure mediums in terms of privacy and confidentiality so our policy regarding, electronic communication, and cell phone use includes the following: • We do not provide therapy/counseling via email or text messaging. • Text messaging and email will be used for administrative tasks only (as defined above). • Therapists may not acknowledge or return emails or text messages that are not administrative. This includes emergency texts and emails. • If your therapist leaves for an extended period of time you will be given the information for another licensed therapist with whom you may schedule if you need an appointment during your therapist’s absence. You may need to fill out other paperwork if therapist is in another practiceneeds.

Counseling Services. Your Therapy is a relationship between people that works in part because of clearly defined rights and responsibilities held by each person. As a client in mental health counseling, you have certain rights and responsibilities that are important for you to understand. There are also legal limitations to those rights that you should be aware of. I, as your therapist, have corresponding responsibilities to you. These rights and responsibilities are described in the following sections. Mental Health Counseling has both benefits and risks. Risks may include experiencing uncomfortable feelings, such as sadness, guilt, anxiety, anger, frustration, loneliness and helplessness, because the process of psychotherapy often requires discussing the unpleasant aspects of your life. However, psychotherapy has been shown to have benefits for individuals who undertake it. Therapy often leads to a significant reduction in feelings of distress, increased satisfaction in interpersonal relationships, greater personal awareness and insight, increased skills for managing stress and resolutions to specific problems. But, there are no guarantees about what will happen. Psychotherapy requires a very active effort on your part. In order to be most successful, you will have to work on things we discuss in treatment outside of sessions, as a kind of homework. The first appointment (or more, in some cases) 2 sessions will involve an assessment a comprehensive evaluation of your needs. By the end of the assessment your counselor evaluation, I will be able to offer you some first initial impressions of what our work might include. At that point, we will discuss your work may include treatment goals and recommendations for getting helpcreate an initial treatment plan. One of the recommendations may be psychotherapy. If so, ABO may or may not be able to provide you with psychotherapy, depending on your overall needs. If psychotherapy or any other recommendations suggested by your counselor include things that ABO cannot provide, you will be given suggestions of where you might receive those services. Wherever you choose to obtain treatment, you You should evaluate the this information from your initial assessment along with and make your own opinions of what sort of treatment you are willing to do and assessment about whether you feel comfortable working with the treating clinician. Therapy involves a large commitment of time, energy, and often money, so you should be very careful about the counselor you selectme. If you have questions about the procedures used or conclusions made by your counselor at ABOmy procedures, please we should discuss them whenever they arise. If your doubts persist, your counselor I will be happy to help you set up a meeting with another mental health professional for a second opinion. Psychotherapy is not easily described in general statements. It varies depending on the particular problems you are experiencing, the therapeutic methods used by your counselor, and the personalities of the counselor and client. There are many different methods counselors may use opinion or to deal with the problems make a move to another therapist that you hope to address. Psychotherapy is not feels like a medical doctor visitbetter fit. InsteadAPPOINTMENTS: Appointments will ordinarily be 60 minutes in duration, it calls for a very active effort on your part. In order for the therapy to be most successful, you will have to work on things that are discussed both during your sessions and on your own. Psychotherapy can have benefits and risks. Since therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, shame, frustration, loneliness, and helplessness. The changes you make in therapy may also affect your relationships in unexpected ways. Psychotherapy has also been shown to have many benefits. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress. But there are no guarantees of what you will experience. MEETINGS The initial assessment will last from one to four sessions. During this time, you and your counselor can both decide if she/he is the best person to provide the services you need in order to meet your treatment goals. If you choose to begin psychotherapy, your counselor will usually schedule one meeting once per week at a time you each we agree on, although some sessions may be more or less frequent as needed. Once an The time scheduled for your appointment is scheduled, assigned to you will be expected to attend unless and you provide advance notice of cancellationalone. If you need to cancel an appointmentor reschedule a session, I ask that you provide me with 24 hours notice. It is important to note that insurance companies do not provide reimbursement for cancelled sessions; thus, if I do not receive enough notice to fill that spot with another client I have no income for that time slot. If it is your responsibility possible, I will try to contact us find another time to cancel. PROFESSIONAL FEES Fees will be collected when services are rendered.*In addition to therapy services fees may include assessment administration, scoring, and reporting; creating reports; creating copies of records on request; and consulting with other professionals at reschedule the client’s request. There will be an additional $25 fee assessed for any returned check. CHANGES AND CANCELLATIONS We understand that there are unforeseeable circumstances like sick children or bad weather. Your appointment is important though, and your therapist is happy to contact you for a phone session or a session via our HIPPA-compliant virtual therapy system so you don't need to leave your sick child or worry about traffic and weather. As long as you are in a confidential location, we can help you keep your regularly scheduled appointment. If you still must change or cancel your counseling appointment, please know: • Cancellations must be made during business hours. • Cancellations must be made within 48 hours of session time if using our online scheduling program. • We cannot accommodate cancellations made via email as we do not monitor email on a regular basis. • We may not accommodate cancellations made after hours or on holidays to our main number as we cannot check voice mail regularly. If you have an appointment on a Monday or the first day following a holidayIn addition, you must make your change or cancellation the last business day before your appointment. • Cancellations with less than 24 hours’ notice will result in a fee equal to the total amount of the missed session that will be collected at your next appointment, or, if payment information is on file, it will be debited from your credit card. • *After two no-shows/late cancellations, you will pre-pay a retainer before scheduling any future appointments. • Clients who have pre-paid agree to have the entire fee deducted from their pre-payment in cases of other no-shows and late changes/cancellations. COURT TESTIMONY • Court testimony costs begin at $250 per hour with a minimum charge of three hours. A retainer of $1000 is due one week prior to the court date. Travel is billed at .55/mile. Failure to provide the specific fees as described constitutes a release from the requested court appearance. • It is required that a minimum of 36 hours’ notice be given if the testimony is not required, otherwise the entire retainer may be forfeited. If proper notice is given, the retainer will be refunded. • Additional services related to court preparation including all correspondence with attorneys or other service providers via phone, email, or letter, documentation review and/or documentation preparation are also billed at $250 per hour, rounded to the nearest 15 minute increment. You (not your insurance company) are responsible for full payment of fees. It is very important that you find out exactly what mental health services coming to your insurance policy covers. You must pay your xxxx first, then contact your insurance company regarding reimbursement. CONTACTING US We answer our main office number 9:00 AM – 5:00 PM Monday through Friday (except holidays). You may have your counselor’s cell phone number in order to coordinate administrative tasks (defined as appointment arrival, appointment session on time, and directions). Email, and text messaging are not secure mediums in terms of privacy and confidentiality so our policy regarding, electronic communication, and cell phone use includes the following: • We do not provide therapy/counseling via email or text messaging. • Text messaging and email will be used for administrative tasks only (as defined above). • Therapists may not acknowledge or return emails or text messages that are not administrative. This includes emergency texts and emails. • If your therapist leaves for an extended period of time you will be given the information for another licensed therapist with whom you may schedule ; if you need an are late, your appointment during your therapist’s absence. You may will still need to fill out other paperwork if therapist is in another practiceend on time.

Counseling Services. Your first appointment (or more, in some cases) will involve an assessment of your needs. By the end of the assessment your counselor will be able to offer you some first impressions of what your work may include and recommendations for getting help. One of the recommendations may be psychotherapy. If so, ABO may or may not be able to provide you with psychotherapy, depending on your overall needs. If psychotherapy or any other recommendations suggested by your counselor include things that ABO cannot provide, you will be given suggestions of where you might receive those services. Wherever you choose to obtain treatment, you should evaluate the information from your initial assessment along with your own opinions of what sort of treatment you are willing to do and whether you feel comfortable working with the treating clinician. Therapy involves a large commitment of time, energy, and often money, so you should be very careful about the counselor you select. If you have questions about the procedures used or conclusions made by your counselor at ABO, please discuss them whenever they arise. If your doubts persist, your counselor will be happy to help you set up a meeting with another mental health professional for a second opinion. Psychotherapy is not easily described in general statements. It Counseling varies depending on the particular problems you are experiencing, the therapeutic methods used by your counselor, and the personalities of the counselor and client, and the particular problem you bring to counseling. There are many different methods counselors may use to deal with the problems that you hope to address. Psychotherapy is not like a medical doctor visit. InsteadCounseling will frequently involve discussing your personal concerns, it calls for a very active effort on your partthoughts and feelings. In order for the therapy counseling to be most successful, you will have to work on things that are discussed we talk about both during your our sessions and on your ownbetween sessions. Psychotherapy Counseling can have benefits risks and risksbenefits. Since therapy often involves discussing unpleasant aspects of your lifeInitially, you may experience uncomfortable feelings like levels of sadness, guilt, anxiety, anger, shame, frustration, loneliness, and helplessness, or other negative feelings. The changes While you make in therapy may also affect your relationships in unexpected ways. Psychotherapy has also consider these risks, you should always know that the benefits of psychotherapy have been shown to have many benefitsby scientists in hundreds of well-designed research studies. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress, improvements in relationships, acquisition of skills to cope with stress, and improvement in overall well-being. But there are no guarantees of what you will experience. MEETINGS The initial assessment Our first session together will last from one to four sessionsinclude an evaluation of your needs. During this timeAt the end of that meeting, I will offer you some first impressions of what our work will include and your counselor can both decide if she/he is the best person to provide the services you need in order to meet your a treatment goalsplan that we will follow. If you choose have questions about our process, we should discuss them whenever they arise. I will be glad to provide outside referrals if your concerns continue. CONSULTATION SERVICES As an expert and experienced geriatric social service and mental health professional, I am available to offer consultation on specific situations or concerns you’d like suggestions or advice about. Consultation is not a psychotherapeutic service and we will not be discussing your feelings or personal needs, however I would be glad to begin psychotherapypsychotherapy services if we agree that they would be beneficial. Common concerns that clients might ask for professional advice on are decisions about retirement, housing options, decisions about moving to a higher level of care, or advice about managing difficult situations in caregiving, navigating the health care system or end-of-life decisions. I am careful not to offer advice about legal or medical situations or decision making. While my suggestions and recommendations are based upon professional expertise and experience, the outcome of the particular situation is not guaranteed. Consultation is generally conducted over a few meetings. Reports with impressions and recommendations can be provided. TELEMENTAL HEALTH SERVICES In addition to meeting together in my office, I offer counseling over the phone or on video chat. Telemental health is the use of telephone and video technology for delivery of counseling services. These services can be beneficial in the situation where clients are unable to meet in my office for some reason. Telemental health has been shown to be beneficial as a mode of providing psychotherapy but does come with some potential risks including: less control over confidentiality, decreased emotional connection between therapist and client and reducing the likelihood of insurance reimbursement. While we may agree that telemental health is effective in your counselor situation, we will usually schedule one meeting need to discuss how often you will return for face-to-face visits. We will regularly review whether telemental health is continuing to be beneficial. My license covers telemental health services to residents of California only. If telemental health is appropriate for you, then I will provide this services through a HIPAA compliant system. These services claim to be HIPAA compliant and reliable, however I cannot guarantee there will not be concerns of service reliability, potential interruptions of services, security, or confidentiality. A session may have to be moved to phone or discontinued if service interruptions or delays occur. Clients are encouraged to research and understand the benefits and limits of this form of technology before using it. To increase security, it is recommended that you use a computer or mobile device that has up to date antivirus software and a personal firewall installed. It is recommended that videoconferencing be completed on an internet service at a time you bandwidth of 384 kbps or higher in each agree onof the downlink and uplink directions. Once an appointment is scheduledSuch services should provide a minimum of 640 x 360 resolution at 30 frames per second. As a client of telemental health services, you are responsible for maintaining privacy on your end of the communication (e.g., storing electronic documents securely, ensuring sessions are not overheard, verifying that you are sending information to the correct recipient, avoiding use of employer-owned computers if employers have access to materials on the computer or network). Signing this consent indicates that you understand the risks in using technology for counseling. HOME VISITS On some occasions, I may be able to meet you in your home to conduct therapy. In these cases, I will arrive 10 minutes early so that we can get comfortable, start on time and end at 50 minutes, just like a traditional session. Please assure that we have privacy and are not interrupted. CRISIS SERVICES My practice is part-time and I may not be expected to attend unless available when you provide advance notice of cancellationneed crisis counseling. If you need more frequent contact than I am able to cancel provide in our regular sessions, I can provide referrals to clinicians who can provide this service. In the case of an appointmentemergency, it is please call the Santa Clara County Crisis Line (000-000-0000), dial 911 or go to your responsibility to contact us to cancellocal emergency room. MEETINGS, PROFESSIONAL FEES Fees AND CANCELLATION POLICIES A free 30-minute meeting is available prior to beginning counseling. You should evaluate our conversation along with your own opinions of whether you feel comfortable working with me. Therapy involves a large commitment of time, money and energy, so you should be very careful about the therapist you select. I offer traditional 50-minute appointments. The fee for a 50-minute session is $170.00. Mileage will be collected when services are rendered.*In charged for home visits at the following rate: $50.00 within 2 miles of my office $75.00 within 5 miles of my office $100.00 within 8 miles of my office In addition to therapy these fees, I charge for additional services fees you may include assessment administration, scoring, and reporting; creating reports; creating copies of records on request; and consulting with other professionals need: Consultation reports are billed at the client’s request. There will be an additional $25 fee assessed for any returned check. CHANGES AND CANCELLATIONS We understand that there are unforeseeable circumstances like sick children or bad weather. Your appointment is important though, and your therapist is happy to contact you for a phone session or a session via our HIPPA-compliant virtual therapy system so you don't need to leave your sick child or worry about traffic and weather. As long as you are in a confidential location, we can help you keep your regularly scheduled appointment. If you still must change or cancel your counseling appointment, please know: • Cancellations must be made during business hours. • Cancellations must be made within 48 hours of session time if using our online scheduling program. • We cannot accommodate cancellations made via email as we do not monitor email on a regular basis. • We may not accommodate cancellations made after hours or on holidays to our main number as we cannot check voice mail regularly. If you have an appointment on a Monday or the first day following a holiday, you must make your change or cancellation the last business day before your appointment. • Cancellations with less than 24 hours’ notice will result in a fee equal to the total amount of the missed session that will be collected at your next appointment, or, if payment information is on file, it will be debited from your credit card. • *After two no-shows/late cancellations, you will pre-pay a retainer before scheduling any future appointments. • Clients who have pre-paid agree to have the entire fee deducted from their pre-payment in cases of other no-shows and late changes/cancellations. COURT TESTIMONY • Court testimony costs begin at $250 per hour with a minimum charge of three hours. A retainer rate of $1000 is due one week prior to the court date170/hour broken down into 10-minute increments. Travel is billed at .55/mile. Failure to provide the specific fees as described constitutes a release from the requested court appearance. • It is required Legal proceedings that a minimum of 36 hours’ notice require my participation will also be given if the testimony is not required, otherwise the entire retainer may be forfeited. If proper notice is given, the retainer will be refunded. • Additional services related to court preparation including all correspondence with attorneys or other service providers via phone, email, or letter, documentation review and/or documentation preparation are also billed at $250 per hour, rounded to the nearest 15 minute increment. You (not your insurance company) are responsible for full payment of fees. It is very important that you find out exactly what mental health services your insurance policy covers. You must pay your xxxx first, then contact your insurance company regarding reimbursement. CONTACTING US We answer our main office number 9:00 AM – 5:00 PM Monday through Friday (except holidays). You may have your counselor’s cell phone number in order to coordinate administrative tasks (defined as appointment arrival, appointment time, and directions). Email, and text messaging are not secure mediums in terms of privacy and confidentiality so our policy regarding, electronic communication, and cell phone use includes the following: • We do not provide therapy/counseling via email or text messaging. • Text messaging and email will be used for administrative tasks only (as defined above). • Therapists may not acknowledge or return emails or text messages that are not administrative. This includes emergency texts and emails. • If your therapist leaves for an extended period of time you will be given the information for another licensed therapist with whom you may schedule if you need an appointment during your therapist’s absence. You may need to fill out other paperwork if therapist is in another practicebilled.

Counseling Services. Your first appointment (or more, in some cases) will involve an assessment of your needs. By the end of the assessment your counselor will be able to offer you some first impressions of what your work may include and recommendations for getting help. One of the recommendations may be psychotherapy. If so, ABO may or may not be able to provide you with psychotherapy, depending on your overall needs. If psychotherapy or any other recommendations suggested by your counselor include things that ABO cannot provide, you will be given suggestions of where you might receive those services. Wherever you choose to obtain treatment, you should evaluate the information from your initial assessment along with your own opinions of what sort of treatment you are willing to do and whether you feel comfortable working with the treating clinician. Therapy involves a large commitment of time, energy, and often money, so you should be very careful about the counselor therapist you select. If you have questions about the procedures used or conclusions made by your counselor at ABO, please discuss them whenever they arise. If your doubts persist, your counselor will be happy to help you set up a meeting with another mental health professional for a second opinion. Psychotherapy is not easily described in general statements. It varies depending on the particular problems you are experiencing, the therapeutic methods used by your counselor, and the personalities of the counselor and client. There are many different methods counselors may use to deal with the problems that you hope to address. Psychotherapy is not like a medical doctor visit. Instead, it calls for a very active effort on your part. In order for the therapy to be most successful, you will have to work on things that are discussed both during your sessions and on your own. Psychotherapy can have benefits and risks. Since therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, shame, frustration, loneliness, and helplessness. The changes you make in therapy may also affect your relationships in unexpected ways. Psychotherapy has also been shown to have many benefits. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress. But there are no guarantees of what you will experience. MEETINGS The initial assessment will last from one to four two sessions. During this time, you and your counselor can both decide if she/he is the best person to provide the services you need in order to meet your treatment goals. If you choose to begin psychotherapypsychotherapy is begun, your counselor will usually schedule one meeting per week at a time you each agree on. Once an appointment is scheduled, you will be expected to attend unless you provide advance notice of cancellation. If you need to cancel an appointment, it is your responsibility to contact us to cancel. PROFESSIONAL FEES Fees will be collected when services are rendered.*In rendered. In addition to therapy services fees may include assessment administration, scoring, and reporting; creating reports; creating copies of records on request; and consulting with other professionals at the client’s request. There will be an additional $25 fee assessed for any returned check. CHANGES AND CANCELLATIONS We understand that there are unforeseeable circumstances like sick children or bad weather. Your appointment is important though, and your therapist is happy to contact you for a phone session or a session via our HIPPA-compliant virtual therapy system so you don't need to leave your sick child or worry about traffic and weather. As long as you are in a confidential location, we can help you keep your regularly scheduled appointment. If you still must change or cancel your counseling appointment, appointment please know: • Cancellations must be made during business hours. • Cancellations must be made within 48 hours of session time if using our online scheduling program. • We cannot accommodate cancellations made via email as we do not monitor email on a regular basis. • We may cannot accommodate cancellations made after hours or on holidays to our main number as we cando not check accept voice mail regularlymail. If you have an appointment on a Monday or the first day following a holiday, you must make your change or cancellation the last business day before your appointment. • Cancellations with less than 24 hours’ hours notice will result in a fee equal to the total amount of the missed session that will be collected at your next appointment, or, if payment information is on file, it will be debited from your credit card. • *After two no-shows/late cancellations, you will pre-pay a retainer before scheduling any future appointments. • Clients who have pre-paid agree to have the entire fee deducted from their pre-payment in cases of other no-shows and late changes/cancellations. COURT TESTIMONY • Court testimony costs begin at $250 per hour with a minimum charge of three hours. A retainer of $1000 is due one week prior to the court date. Travel is billed at .55/mile. Failure to provide the specific fees as described constitutes a release from the requested court appearance. • It is required that a minimum of 36 hours’ notice be given if the testimony is not required, otherwise the entire retainer may be is forfeited. If proper notice is given, the retainer will be refunded. • Additional services related to court preparation including all correspondence with attorneys or other service providers via phone, email, or letter, documentation review and/or documentation preparation are also billed at $250 per hour, rounded to the nearest 15 minute increment. You (not your insurance company) are responsible for full payment of fees. It is very important that you find out exactly what mental health services your insurance policy covers. You must pay your xxxx first, then contact your insurance company regarding reimbursement. CONTACTING US We answer our main office number 9:00 8:00 AM – 5:00 PM Monday through Friday (except holidays). You may have your counselor’s cell phone number in order to coordinate administrative tasks (defined as appointment arrival, appointment time, and directions). Email, and text messaging are not secure mediums in terms of privacy and confidentiality so our policy regarding, electronic communication, and cell phone use includes the following: • We do not provide therapy/counseling via email or text messaging. • Text messaging and email will be used for administrative tasks only (as defined above). • Therapists may not acknowledge or return emails or text messages that are not administrative. This includes emergency texts and emails. • If your therapist leaves for an extended period of time you will be given the information for another licensed therapist with whom you may schedule if you need an appointment during your therapist’s absence. You may need to fill out other paperwork if therapist is in another practice.

Counseling Services. Your first appointment (or more, in some cases) will involve an assessment of your needs. By the end of the assessment your counselor I will be able to offer you some first impressions of what your work may include and recommendations for getting help. One of the recommendations may be psychotherapy. If so, ABO may or may not be able to provide you with psychotherapy, depending on your overall needs. If psychotherapy or any other recommendations suggested by your counselor me include things that ABO cannot provide, you will be given suggestions of where you might receive those services. Wherever you choose to obtain treatment, you should evaluate the information from your initial assessment along with your own opinions of what sort of treatment you are willing to do and whether you feel comfortable working with the treating clinician. Therapy involves a large commitment of time, energy, and often money, so you should be very careful about the counselor you select. If you have questions about the procedures used or conclusions made by your counselor at ABOme, please discuss them whenever they arise. If your doubts persist, your counselor I will be happy to help you set up a meeting with another mental health professional for a second opinion. Psychotherapy is not easily described in general statements. It varies depending on the particular problems you are experiencing, the therapeutic methods used by your counselor, and the personalities of the counselor and client. There are many different methods counselors may use to deal with the problems that you hope to address. Psychotherapy is not like a medical doctor visit. Instead, it calls for a very active effort on your part. In order for the therapy to be most successful, you will have to work on things that are discussed both during your sessions and on your own. Psychotherapy can have benefits and risks. Since therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, shame, frustration, loneliness, and helplessness. The changes you make in therapy may also affect your relationships in unexpected ways. Psychotherapy has also been shown to have many benefits. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress. But there are no guarantees of what you will experience. MEETINGS The initial assessment will last from one to four sessions. During this time, you and your counselor I can both decide if she/he I am is the best person to provide the services you need in order to meet your treatment goals. If you choose to begin psychotherapy, your counselor I will usually schedule one meeting at a time you each agree onupon. Once an appointment is scheduled, you will be expected to attend unless you provide advance notice of cancellationcancelation. If you need to cancel an appointment, it is your responsibility to contact us me to cancel. PROFESSIONAL FEES Fees will be collected when services are rendered.*In rendered. In addition to therapy services fees may include assessment administration, scoring, and reporting; creating reports; creating copies of records on request; and consulting with other professionals at the client’s request. There will be an additional $25 fee assessed for any returned check. The fee for my services is $200 per hour. CHANGES AND CANCELLATIONS We CANCELATIONS I understand that there are unforeseeable circumstances like sick children or bad weather. Your appointment is important though, and your therapist is I am happy to contact you for a phone session or a session via our HIPPAa HIPAA-compliant virtual therapy system so you don't need to leave your sick child or worry about traffic and weather. As long as you are in a confidential location, we I can help you keep your regularly scheduled appointment. If you still must change or cancel your counseling appointment, please know: • Cancellations must be made during business hours. • Cancellations Cancelations must be made within 48 hours of session time if using by: o Contacting us at 000-000-0000 and leaving a voice mail o Using our online scheduling program, log in to your account and change or cancel your appointment. • We cannot accommodate cancellations made via email as we do not monitor take cancelations via email. Emails from our scheduling software are automated and clearly marked ‘no reply.’ Replies to our email on a regular basisare not monitored. • We I may not accommodate cancellations cancelations made after hours or on holidays to our main number as we I cannot check voice mail regularly. If you have an appointment on a Monday or the first day following a holiday, you must make your change or cancellation cancelation the last business day before your appointment. • Cancellations Cancelations with less than 24 hours’ notice will result in a fee equal to the total amount of the missed session that will be collected at your next appointment, or, if payment information is on file, it will be debited from your credit card. • *After two no-shows/late cancellationscancelations, you will pre-pay a retainer before scheduling any future appointments. • Clients who have pre-paid agree to have the entire fee deducted from their pre-payment in cases of other no-shows and late changes/cancellationscancelations. Any money left over from retainer after no-show fee is deducted will be refunded. COURT TESTIMONY • Court testimony costs begin at $250 per hour with a minimum charge of three hours. A retainer of $1000 is due one week prior to the court date. Travel is billed at .55/mile. Failure to provide the specific fees as described constitutes a release from the requested court appearance. • It is required that a minimum of 36 hours’ notice be given if the testimony is not required, otherwise the entire retainer may be forfeited. If proper notice is given, the retainer will be refunded. • Additional services related to court preparation including all correspondence with attorneys or other service providers via phone, email, or letter, documentation review and/or documentation preparation are also billed at $250 per hour, rounded to the nearest 15 minute increment. You (not your insurance company) are responsible for full payment of fees. It is very important that you find out exactly what mental health services your insurance policy covers. You must pay your xxxx first, then contact your insurance company regarding reimbursement. CONTACTING US We ME I answer our the main office number 9:00 AM – 5:00 PM Monday through Friday (except holidays). You may have your counselor’s cell phone number in order to coordinate administrative tasks (defined as appointment arrival, appointment time, and directions). Email, and text messaging are not secure mediums in terms of privacy and confidentiality so our my policy regarding, electronic communication, and cell phone use includes the followingis: • We I do not provide therapy/counseling via email or text messaging. • Text messaging and email will be used for administrative tasks only (as defined above). • Therapists I may not acknowledge or return emails or text messages messages. Our scheduling software uses ‘No reply’ email confirmations and text messaging so I will not see any emails or text message replies to that are not administrative. This includes emergency texts and emailsservice. • If your therapist leaves I leave for an extended period of time you will be given the information for another licensed therapist with whom you may schedule if you need an appointment during your therapist’s my absence. You may Keep in mind you will need to fill out other paperwork if therapist paperwork. • Social media is in another practicenot a means of communication. If you find me on social media, I will not communicate with you.