Counseling Services. Counseling is not easily described in general statements. It varies depending on the personality of the counselor and the client, as well as the problems and challenges you bring forward. There are many different methods I may use to deal with the problems you want to address. Counseling is not like a medical doctor visit. Instead, it requires a very active effort on your part. In order for the counseling to be most successful, you will need to work on the areas we talk about both during our sessions and especially in between sessions. Counseling can have both benefits and risks. Since counseling often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness and helplessness. Counseling often leads to better relationships, solutions to specific problems and significant reductions in feelings of distress, however, there are no guarantees of what you will experience. By signing this document, you agree to not hold Cara Damier liable or responsible for any results or outcomes of counseling or coaching and to also not seek out legal action against Xxxx Xxxxxx for any reason. Our first few sessions will involve an evaluation of your needs. By the end of the evaluation, I will be able to offer you some first impressions of what our work will entail and develop a treatment plan to follow should you decide to continue with counseling. You should evaluate this information along with your own opinions of whether you feel comfortable working with me. Counseling involves a significant commitment of time, money and energy, so you should be very careful about the counselor you select. If you have any questions about my approach or procedures, we should discuss them whenever they arise. This agreement is for Counseling or Coaching. While counseling and coaching can work with issues such as identifying and reaching life goals, and changing the behaviors that aren’t working well for you, counseling/coaching is not intended to work through issues such as schizophrenia and suicidal behaviors. For issues such as these, you must see a Physician or Licensed Mental Health Professional in your location. By signing this agreement, you are agreeing that you understand the difference in these two functions and you will get appropriate professional help for mental health issues if necessary. Please feel free to ask questions at any time about your counselor’s/coach’s background, experience and professional orientation.
Appears in 1 contract
Samples: Counseling/Coaching Agreement
Counseling Services. Counseling SUD therapy/counseling is not easily described a relationship between people that works in general statementspart because of clearly defined rights and responsibilities held by each person. It varies depending on As a client in the personality of the counselor SUD counseling process, you have certain rights and the client, as well as the problems and challenges responsibilities that are important for you bring forwardto understand. There are many different methods I may use also legal limitations to deal with 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 problems you want to addressfollowing sections. Counseling is not like a medical doctor visit. Instead, it requires a very active effort on your part. In order for the SUD therapy/counseling to be most successful, you will need to work on the areas we talk about has both during our sessions and especially in between sessions. Counseling can have both benefits benefits and risks. Since counseling often involves discussing unpleasant aspects of your lifeRisks may include experiencing uncomfortable feelings, you may experience uncomfortable feelings like such as sadness, guilt, anxiety, anger, frustration, loneliness and helplessness, because the process of therapy often requires discussing the unpleasant aspects of your life. Counseling However, therapy has been shown to have benefits for individuals who undertake it. Therapy often leads to better relationships, solutions to specific problems and significant reductions a significant reduction in feelings of distress, howeverincreased satisfaction in interpersonal relationships, greater personal awareness and insight, increased skills for managing stress and resolutions to specific problems. But, there are no guarantees of about what will happen. Therapy requires a very active effort on your part. In order to be most successful, you will experiencewant to put into practice things we discuss outside of sessions. By signing this document, you agree to not hold Cara Damier liable or responsible for any results or outcomes of counseling or coaching and to also not seek out legal action against Xxxx Xxxxxx for any reason. Our first few The first 2-3 sessions will involve an a comprehensive evaluation of your needs. By the end of the evaluation, I will be able to offer offer you some first initial impressions of what our work might include. At that point, we will entail discuss your treatment goals and develop a create an initial treatment plan to follow should you decide to continue with counselingplan. You should evaluate this information along with and make your own opinions of assessment about whether you feel comfortable working with me. Counseling involves a significant commitment of time, money and energy, so you should be very careful about the counselor you select. If you have any questions about my approach or procedures, we should discuss them whenever they arise. This agreement If your doubts persist, I will be happy to help you set up a meeting with another SUD professional for a second opinion. PROFESSIONAL FEES The standard fee for a 50-minute individual session is $125.00 and the standard fee for Counseling a 90 minute couples session is $175.00 You are responsible for paying the full amount at the time of your session, unless prior arrangements have been made. Payment must be made by cash, or Coachingcredit card. While counseling If you refuse to pay your debt, I reserve the right to use an attorney or collection agency to secure payment. APPOINTMENTS Appointments will ordinarily be 45-60 minutes in duration, once per week at a time we agree on, although some sessions may be more, or less frequent as needed. The time scheduled for your appointment is assigned to you and coaching can work you alone. If you need to cancel or reschedule a session, I ask that you provide me with issues such as identifying and reaching life goals24-hours notice. If you miss a session without canceling, and changing or cancel with less than 24-hour notice, my policy is to collect the behaviors full session fee of $125.00/individual or $175.00/couples. It is important to note that aren’t working well insurance companies do not provide reimbursement for you, counseling/coaching is not intended to work through issues such as schizophrenia and suicidal behaviors. For issues such as thesecancelled sessions; thus, you must see a Physician or Licensed Mental Health Professional in your locationwill be responsible for 100% of the full rate. By signing this agreementIf it is possible, I will try to find another time to reschedule the appointment. In addition, you are agreeing responsible for coming to your session on time; if you are late, your appointment will still need to end at the scheduled time. Finally, I have the right to terminate 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 RECORDS I am required to keep appropriate records of the SUD therapy/counseling services that I provide. Your records are maintained in a secured, encrypted, HIPAA compliant web-based system. I keep brief records noting that you understand were here, your reasons for seeking SUD therapy/counseling, the difference goals and progress we set for treatment, your diagnosis, topics we discussed, your medical, social, and treatment history, records I receive from other providers, copies of records I send to others, and your billing records. Except in unusual circumstances that involve danger to yourself, you have the right to a copy of your file. Because these two functions are professional records, they may be misinterpreted and / or upsetting to untrained readers. For this reason, I recommend that you will get appropriate professional help for initially review them with me, or have them forwarded to another mental health issues if necessaryprofessional to discuss the contents. Please feel free You also have the right to ask questions request that a copy of your file be made available to any other health care provider at any time about your counselor’s/coach’s background, experience and professional orientationwritten request.
Appears in 1 contract
Samples: Counselor/Client Service Agreement
Counseling Services. Counseling Your first appointment (or more, in some cases) will involve an assessment of your needs. By the end of the assessment Xxxx Xxxxxx 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, Xxxx Xxxxxx 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 Xxxx Xxxxxx Counseling, Inc. 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 Xxxx Xxxxxx. Therapy involves a large commitment of time, energy, and often money, so you should be very careful about the therapist you select. If you have questions about the procedures used or conclusions made by Xxxx Xxxxxx, 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 personality particular problems you are experiencing, the therapeutic methods used by your counselor, and the personalities of the counselor and the client, as well as the problems and challenges you bring forward. There are many different different methods I counselors may use to deal with the problems that you want hope to address. Counseling Psychotherapy is not like a medical doctor visit. Instead, it requires calls for a very active effort effort on your part. In order for the counseling therapy to be most successful, you will need have to work on the areas we talk about things that are discussed both during our your sessions and especially in between sessionson your own. Counseling Psychotherapy can have both benefits benefits and risks. Since counseling therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, shame, frustration, loneliness loneliness, and helplessness. Counseling 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 specific problems, and significant significant reductions in feelings of distress, however, . But there are no guarantees of what you will experience. By signing The initial assessment will last from one to two sessions. During this documenttime, you and Xxxx Xxxxxx can both decide if she is the best person to provide the services you need in order to meet your treatment goals. If psychotherapy is begun it is typical to schedule one meeting per week at a time you each agree on. Once an appointment is scheduled, you will be expected to not hold Cara Damier liable or responsible attend unless you provide advance notice of cancellation. If you need to cancel an appointment, it is your responsibility to contact us to cancel. Fees will be collected when services are rendered. The fee per 50 minute counseling session is $135, and will be adjusted accordingly when 50 minutes is exceeded. In addition to therapy services fees may include 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 results returned check. We understand that there are unforeseeable circumstances like sick children or outcomes of counseling or coaching bad weather. Your appointment is important though, and to also not seek out legal action against Xxxx Xxxxxx is happy to contact you for any reason. Our first few sessions will involve an evaluation of your needs. By the end of the evaluation, I will be able to offer you some first impressions of what a phone session or a session via our work will entail and develop a treatment plan to follow should you decide to continue with counseling. You should evaluate this information along with your own opinions of whether you feel comfortable working with me. Counseling involves a significant commitment of time, money and energy, HIPPA-compliant virtual therapy system so you should 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 very careful about the counselor you selectmade within 24 hours of session time. ● We cannot accommodate cancellations made via email as we do not monitor email on a regular basis. ● We cannot accommodate cancellations made after hours or on holidays. If you have any questions about my approach an appointment on a Monday or procedures, we should discuss them whenever they arise. This agreement is for Counseling or Coaching. While counseling and coaching can work with issues such as identifying and reaching life goals, and changing the behaviors that aren’t working well for you, counseling/coaching is not intended to work through issues such as schizophrenia and suicidal behaviors. For issues such as thesefirst day following a holiday, you must see make your change or cancellation the last business day before your appointment. ● Cancellations with less than 24 hours’ notice will result in a Physician or Licensed Mental Health Professional $90 fee 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, a pre-paid retainer will be required 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 costs begin at $300 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. You (not your locationinsurance company) are responsible for full payment of fees. By signing this agreement, you are agreeing It is very important that you understand find out exactly what mental health services your insurance policy covers. You must pay your xxxx first, then contact your insurance company regarding reimbursement. You can contact our main office number (281-350-1277) 24 hours a day/7 days a week. If an administrative assistant or Xxxx Xxxxxx, does not answer, please leave a message on the difference internal/secure voicemail system. Messages are typically returned within 24 hours during the business week, or 48 hours for messages left on the weekend. You may have your counselor’s cell phone number in these two functions 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). ● Xxxx Xxxxxx Counseling, Inc., may not acknowledge or return emails or text messages that are not administrative. This includes emergency texts and emails. ● If Xxxx Xxxxxx leaves for an extended period of time you will get appropriate professional help be given the information for mental health issues another licensed therapist with whom you may schedule if necessary. Please feel free to ask questions at any time about you need an appointment during your counselor’s/coachtherapist’s background, experience and professional orientationabsence.
Appears in 1 contract
Samples: Client Service Agreement
Counseling Services. Your first appointment (or more, in some cases) will involve an evaluation of your needs. By the end of the evaluation your Clinician 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 individual counseling. It is your choice to start your therapeutic work with the Clinician who assessed you or with someone else. If you decide to work with someone else we are more than willing to help you find the most suitable match for you. Counseling is not easily described in general statements. It varies depending on the personality particular problems you are experiencing, the therapeutic methods used by your Clinician, and the personalities of the counselor Clinician and the client, as well as the problems and challenges you bring forward. There are many different different methods I Clinicians may use to deal with the problems that you want hope to address. Counseling is not like a medical doctor visit. Instead, it requires calls for a very active effort effort on your part. In order for the counseling to be most successful, you will need have to work on the areas we talk about things that are discussed both during our your sessions and especially in between sessionson your own. Counseling can have both benefits benefits and risks. Since counseling often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, shame, frustration, loneliness loneliness, and helplessness. The changes you make in counseling may also affect your relationships in unexpected ways. Counseling has also been shown to have many benefits. Counseling often leads to better relationships, solutions to specific problems specific problems, and significant significant reductions in feelings of distress, however, . But there are no guarantees of what you will experience. By The initial evaluation will last from one to two sessions. During this time, you and your Clinician can both decide if she/he is the best person to provide the services you need in order to meet your treatment goals. If counseling is begun, your Clinician will usually schedule one appointment 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. ◊ Initial Intake Evaluation/ Diagnostic Assessment: $150 per 45 minute session ◊ Individual Counseling (Face to Face/Telehealth): $150 for 60 minute session, $125 per 45 minute session, and $90 for 30 minute session ◊ Family/Couples Counseling: $150 per 45 minute session ◊ Group Counseling: $60 per person per 90 minute session ◊ SAP Evaluations: $475 ($675 for SAP Process) ◊ Summary Letters: $50 per letter ◊ Reports: $100 per report ◊ Missed Appointment/Late Cancellation (less than 24 hrs): $50 ◊ After two no-shows/late cancellations, client may be placed back on the waiting list ◊ Fees for reports, testing, letters, phone calls over 5 minutes, generating reports, consulting with other agencies and professionals at your request, paperwork and depositions resulting from a subpoena, and the time spent performing any other services you may request. These services will be charged as they occur. DLS Clinicians do not testify in court cases unless under subpoena to do so. These services will not be billed to insurance or most third party payers and are therefore your financial responsibility. Payment is due in advance of the service being provided. ◊ Deductible, co-insurance, and/or co-pay amounts, in addition those services not covered by another payer, are due at the time of each visit. ◊ Although we may bill your insurance company and/or third party payer, you are ultimately responsible for payment of services rendered, and for contacting your insurance company and/or third party payer if payment is not received in a timely manner. ◊ If your bill for services rendered is not paid within 30 days, we may find it necessary to turn your account over to a collection agency. We will make every effort to avoid this by working with you to ensure timely payments on your account. However, if it does become necessary to turn your account over to a collection agency, we reserve the right to charge an additional collection fee. ◊ For your convenience, we accept Visa, MasterCard, Cash, Money Orders, Paypal (xxxxxxxxxxxxxxxxxxxx@xxxxx.xxx) and CashApp ($dlsdmv) payments. WE DO NOT ACCEPT CHECKS We answer our main office number (301-804-8279) Monday through Friday, 8am to 5pm. Your Clinician will provide you with their mobile number to contact them in between sessions as needed. Email is not a 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 counseling/counseling via email or text messaging. ◊ Email will be used for administrative tasks only (as defined above). ◊ Clinicians may not acknowledge or return emails or text messages that are not administrative. This includes emergency texts and emails. ◊ Telehealth counseling is allowed if you are within the state of Maryland and/or the District of Columbia and there is completed intake paperwork on file. Insurance coverage of the service varies by plan and often requires prior approval. ◊ If your Clinician leaves for an extended period of time you will be given the information for another licensed Clinician with whom you may contact if you have a crisis during your Clinician’s absence. ◊ If you have an emergency DO NOT contact your Clinician’s cell phone, email, or the main number. Instead go to the nearest emergency department or call 911. Your Clinician should be contacted after the emergency is addressed. Clinicians’ may use Social media, including but not limited to Facebook and Twitter, in this practice as tools for marketing services and disseminating information. Social media of any kind are not secure in terms of privacy and confidentiality so our policy regarding the use of social media includes the following: ◊ We do not provide counseling via social media. ◊ Clinicians will not acknowledge or return private messages delivered via social media. ◊ Clinicians will not acknowledge or respond to client emergencies delivered via social media. ◊ If you have an emergency do not contact your Clinician via social media. Instead go to the emergency room nearest you or call 911. ◊ You may use social media to reveal your own identity as a client of DLS but you may not reveal the identity of another client. Doing so would be a breach of confidentiality and DLS would take all available steps to protect the revealed client’s rights, including blocking the offending client from accessing our social media and referring the offending client to another practice. The law protects the privacy of all communications between a client and a Clinician. In most situations, DLS can only release information about your treatment to others if you sign a written Authorization form that meets certain legal requirements imposed by HIPAA (included with this intake packet). There are other situations that require only that you provide written, advance consent, which is provided by signing this document. Your signature on this Agreement provides consent for the following activities: ◊ Although you will probably meet with only one Clinician, you agree are receiving services from the office of DLS. Consequently, you will have a file in our office to which all Clinicians and staff will have necessary access. We utilize xxxxxxxxx.xxx an online data storage service to store client records. Amazon's servers infrastructure are certified, ensure the highest physical security and guarantee a 99.9% uptime. You can read more at xxxxx://xxx.xxxxxx.xxx/compliance. More information about TheraNest can be obtained at xxxxx://xxx.xxxxxxxxx.xxx/home/faq. ◊ In most cases, we need to share protected information within DLS for both clinical and administrative purposes, such as scheduling, records management, and quality assurance. All of the mental health professionals and staff are bound by the same rules of confidentiality. ◊ In providing, coordinating, or managing your treatment and other services related to your counseling care, DLS sometimes interacts with other professionals concerning your well- being. An example of this would be when we consult with another health care provider, such as a physician. We will acquire a release of information to keep on file if such coordination is necessary. ◊ If you are involved in a court proceeding and a request is made for information concerning your diagnosis and treatment, DLS cannot hold Cara Damier liable provide any information without a) your (or responsible your legal representative’s) written authorization, or b) a court order/subpoena. If you are involved in or contemplating litigation, you should consult with your attorney to determine whether a court would be likely to order DLS to disclose information. ◊ If a client files a complaint or lawsuit against DLS, we may disclose relevant information regarding that client in order to defend ourselves. ◊ If we have reasonable cause to suspect that a child has been or may be subjected to abuse or neglect or observe a child being subjected to conditions or circumstances that would reasonably result in abuse or neglect, the law requires that DLS file a report with the Maryland (MD) Department of Health and Human Services or with the District of Columbia’s (DC)Child & Family Services Agency. Once such a report is filed, we may be required to provide additional information. ◊ If we have reasonable cause to suspect that an elderly or disabled adult presents a likelihood of suffering serious physical harm and is in need of protective services, the law requires that DLS file a report with the MD Department of Health and Human Services or the DC Office of Aging. Once such a report is filed, we may be required to provide additional information. ◊ If we believe that it is necessary to disclose information to protect against a risk of serious harm being inflicted by you upon yourself, another person, or to the community, DLS may be required to take protective action. Depending on the situation, these actions may include initiating hospitalization and/or contacting the police. If such a situation arises, your Clinician will make every effort to fully discuss it with you before taking any action and we will limit our disclosure to what is necessary. ◊ If you disclose past sexual abuse by a mental health provider we are obligated to report this to the proper authorities and licensing entities. ◊ While this written summary of exceptions to confidentiality should prove helpful in informing you about potential problems, it is important that we discuss any questions or concerns that you may have now or in the future. The laws governing confidentiality can be quite complex, and we are not attorneys. In situations where specific advice is required, formal legal advice may be needed. Different methods of providing counseling services are evolving all the time. At DLS we will utilize those means ethically and therapeutically. Technology- assisted distance counseling for individuals, couples, and groups involve the use of the telephone or the computer to enable Clinicians and clients to communicate at a distance when circumstances make this approach necessary or convenient. Telehealth counseling involves synchronous distance interaction among Clinicians and clients using one-to-one or conferencing features of the telephone to communicate or what is seen and heard via video to communicate. Telehealth via video is conducted within our secure HIPAA compliant electronic health record (EHR) system, Theranest. In order to utilize technology for counseling you will be asked to sign a teleheatlh counseling consent form. The laws and standards of our profession require that DLS keeps your Protected Health Information (PHI) about you in your clinical record. Your clinical record includes information about your reasons for seeking counseling, a description of the ways in which your problem impacts on your life, your diagnosis, the goals that we set for treatment, your progress towards those goals, your medical and social history, your treatment history, any results past treatment records that I receive from other providers, reports of any professional consultations, and any reports that have been sent to anyone. Except in the unusual circumstance where disclosure is reasonably likely to endanger you and/or others or outcomes when another individual (other than another health care provider) is referenced and we believe disclosing that information puts the other person at risk of counseling or coaching and to also not seek out legal action against Xxxx Xxxxxx for any reason. Our first few sessions will involve an evaluation substantial harm, you may examine and/or receive a copy of your needsclinical record, if you request it in writing. By Because these are professional records, they can be misinterpreted by and/or be upsetting to untrained readers. For this reason, DLS recommends that you initially review them in your Clinician’s presence, or have them forwarded to another mental health professional so you can discuss the end contents. In most circumstances, DLS is allowed to charge a copying fee of $25 (and for certain other expenses). If DLS refuses your request for access to your clinical records, you have a right of review, which a Clinician will discuss with you upon request. In the event of your Clinician’s death or incapacity, or the termination of the evaluationlicensee’s counseling practice, I all records will be able secured and archived with xxxxxxxxx.xxx records are password protected and will be secured by Xxxxxxxxxx Xxxxxxxxx, Executive Director and Xxxxxxxxx Xxxxxxx, Practice Manager. In the event of your Clinician’s termination, death, or incapacity, all records created as a contract Clinician with DLS will be secured and archived with xxxxxxxxx.xxx on an encrypted electronic server. In the event of the closure of xxxxxxxxx.xxx or the death or incapacitation of its owner, records created by contracted Clinicians will be secured and archived on an encrypted electronic server. Access will be granted to offer Xxxxxxxxxx Xxxxxxxxx or Xxxxxxxxx Xxxxxxx. We are in network for many insurance companies and we are willing to submit claims directly to your carrier for reimbursement. In the event, that we are not in-network with your insurance carrier and you some first impressions of what our work elect to submit your claims for reimbursement we will entail and develop a treatment plan to follow should provide you decide to continue with counselingpaperwork that you need. You should evaluate this information along be aware that in the process of filing for a third party payment, your contract with your own opinions health insurance carrier requires that your Clinician provide additional clinical information such as treatment plans or summaries, a diagnosis, or copies of whether your entire clinical record. This information will become part of the insurance company files and will probably be stored in a computer. Though all insurance companies claim to keep such information confidential, Clinicians have no control over what the insurance companies do with it once it is in their hands. In such situations, your Clinician will make every effort to release only the minimum information about you feel comfortable working with methat is necessary for the purpose requested. Counseling involves a significant commitment Clients under 18 years of time, money age and energy, so you their parents should be very careful aware that the law may allow parents to examine their child’s treatment records. Because privacy in counseling is often crucial to successful progress, particularly with teenagers, it is sometimes our policy to request an agreement from parents that they consent to give up their access to their child’s records. If they agree, during treatment, your Clinician would provide them (if requested) only with general information about the counselor you selectprogress of your treatment, and your attendance at scheduled sessions. If requested, your Clinician could also provide parents with a summary of your treatment when it is complete. Any other communication to your parents will require your authorization, unless we feel that you have any questions about my approach are in danger or proceduresare a danger to someone else, in which case, we should will notify the parents of our concern. Before giving parents any information, your Clinician will discuss them whenever they arise. This agreement is for Counseling or Coaching. While counseling and coaching can work the matter with issues such as identifying and reaching life goalsyou, if possible, and changing do her/his best to handle any objections you may have. In cases of divorce, a copy of the behaviors that aren’t working well for you, counseling/coaching is not intended divorce decree indicating parental rights to work through issues such as schizophrenia view records and suicidal behaviors. For issues such as these, you must see a Physician or Licensed Mental Health Professional participate in your location. By signing this agreement, you are agreeing that you understand the difference in these two functions and you treatment will get appropriate professional help for mental health issues if necessary. Please feel free to ask questions at any time about your counselor’s/coach’s background, experience and professional orientationbe required.
Appears in 1 contract
Samples: Client Services Agreement
Counseling Services. Counseling is not easily described in general statements. It Therapy varies depending on the personality personalities of the counselor therapist and client, and the client, as well as the particular problems and challenges you bring forwardare experiencing. There are many different different methods I we may use to deal with the problems that you want hope to address. Counseling Therapy is not like a medical doctor visit. Instead, it requires calls for a very active effort effort on your part. In order for the counseling therapy to be most successful, you will need have to work on the areas things we talk about both during our sessions and especially in between sessionsat home. Counseling Homework will often be given when deemed necessary for therapy. Therapy can have both benefits benefits and risks. Since counseling therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadnessfeelings. On the other hand, guilt, anger, frustration, loneliness and helplessnesstherapy has also been shown to have many benefits. Counseling Therapy often leads to better relationships, solutions to specific problems specific problems, and significant significant reductions in feelings of distress, however, . But there are no guarantees of what you will experience. By signing this document, you agree to not hold Cara Damier liable or responsible for any results or outcomes of counseling or coaching and to also not seek out legal action against Xxxx Xxxxxx for any reason. Our first first few sessions will involve an evaluation of your needs. By the end of the evaluation, I will be able to offer offer you some first first impressions of what our work will entail include and develop a treatment plan to follow should follow, if you decide to continue with counselingtherapy. You should evaluate this information along with your own opinions of whether you feel comfortable working with me. Counseling Therapy involves a significant large commitment of time, money money, and energy, so you should be very careful about the counselor therapist you select. If you have any questions about my approach or any procedures, we should discuss them whenever they arise. This agreement If your doubts persist, I will be happy to help you set up a meeting with another mental health professional for a second opinion. My goal is for Counseling you to ultimately get the help you need, whether that is with me or Coachingwith another therapist. While counseling and coaching can work with issues such as identifying and reaching life goalsIf therapy is begun, and changing the behaviors that aren’t working well for youwe will usually schedule one 50-minute session (one appointment hour of 50 minutes duration) at a time we agree on, counseling/coaching is not intended to work through issues such as schizophrenia and suicidal behaviors. For issues such as these, you must see a Physician although some sessions may be longer or Licensed Mental Health Professional in your location. By signing this agreement, you are agreeing that you understand the difference in these two functions and you will get appropriate professional help for mental health issues if necessarymore frequent. Please feel free to ask questions at any be on time about your counselor’s/coach’s background, experience and professional orientationas I will often have another session scheduled after you.
Appears in 1 contract
Samples: Therapist Patient Services Agreement
Counseling Services. Counseling Therapy is not easily described a relationship between people that works in general statementspart because of clearly defined rights and responsibilities held by each person. It varies depending on the personality of the counselor As a client in mental health counseling, you have certain rights and the client, as well as the problems and challenges responsibilities that are important for you bring forwardto understand. There are many different methods I may use also legal limitations to deal with 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 problems you want to addressfollowing sections. Mental Health Counseling is not like a medical doctor visit. Instead, it requires a very active effort on your part. In order for the counseling to be most successful, you will need to work on the areas we talk about has both during our sessions and especially in between sessions. Counseling can have both benefits benefits and risks. Since counseling often involves discussing unpleasant aspects of your lifeRisks may include experiencing uncomfortable feelings, you may experience uncomfortable feelings like such as sadness, guilt, anxiety, anger, frustration, loneliness and helplessness, because the process of psychotherapy often requires discussing the unpleasant aspects of your life. Counseling However, psychotherapy has been shown to have benefits for individuals who undertake it. Therapy often leads to better relationships, solutions to specific problems and significant reductions a significant reduction in feelings of distress, howeverincreased satisfaction in interpersonal relationships, greater personal awareness and insight, increased skills for managing stress and resolutions to specific problems. But, there are no guarantees of about what will happen. Psychotherapy requires a very active effort on your part. In order to be most successful, you will experiencehave to work on things we discuss in treatment outside of sessions, as a kind of homework. By signing this document, you agree to not hold Cara Damier liable or responsible for any results or outcomes of counseling or coaching and to also not seek out legal action against Xxxx Xxxxxx for any reason. Our first few The first 2 sessions will involve an a comprehensive evaluation of your needs. By the end of the evaluation, I will be able to offer offer you some first initial impressions of what our work might include. At that point, we will entail discuss your treatment goals and develop a create an initial treatment plan to follow should you decide to continue with counselingplan. You should evaluate this information along with and make your own opinions of assessment about whether you feel comfortable working with me. Counseling involves a significant commitment of time, money and energy, so you should be very careful about the counselor you select. If you have any questions about my approach or procedures, we should discuss them whenever they arise. This agreement is for Counseling or Coaching. While counseling and coaching can work If your doubts persist, I will be happy to help you set up a meeting with issues such as identifying and reaching life goals, and changing the behaviors that aren’t working well for you, counseling/coaching is not intended to work through issues such as schizophrenia and suicidal behaviors. For issues such as these, you must see a Physician or Licensed Mental Health Professional in your location. By signing this agreement, you are agreeing that you understand the difference in these two functions and you will get appropriate professional help for another mental health issues if necessary. Please feel free professional for a second opinion or to ask questions at any time about your counselor’s/coach’s background, experience and professional orientationmake a move to another therapist that feels like a better fit.
Appears in 1 contract
Samples: Counselor Client Service Agreement
Counseling Services. Counseling is not easily described in general statements. It varies depending on the personality personalities of the counselor and the client, as well as and the problems and challenges particular problem you bring forward. There are many different methods I may use to deal with the problems you want to addresscounseling. Counseling is not like a medical doctor visit. Insteadwill frequently involve discussing your personal concerns, it requires a very active effort on your partthoughts and feelings. In order for the counseling to be most successful, you will need have to work on the areas things we talk about both during our sessions and especially in between sessions. Counseling can have both benefits risks and risksbenefits. Since counseling often involves discussing unpleasant aspects of your lifeInitially, you may experience uncomfortable feelings like levels of sadness, guilt, anxiety, anger, frustration, loneliness and loneliness, helplessness, or other negative feelings. Counseling While you consider these risks, you should always know that the benefits of psychotherapy have been shown by scientists in hundreds of well-designed research studies. Therapy often leads to better relationships, solutions to specific problems and significant significant reductions in feelings of distress, howeverimprovements 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. By signing this document, you agree to not hold Cara Damier liable or responsible for any results or outcomes of counseling or coaching and to also not seek out legal action against Xxxx Xxxxxx for any reason. Our first few sessions first session together will involve include an evaluation of your needs. By At the end of the evaluationthat meeting, I will be able to offer offer you some first first impressions of what our work will entail include and develop a treatment plan that we will follow. If you have questions about our process, we should discuss them whenever they arise. I will be glad to follow provide outside referrals if your concerns continue. 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 psychotherapy 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. 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 situation, we will 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 bandwidth of 384 kbps or higher in each of the downlink and uplink directions. Such services should provide a minimum of 640 x 360 resolution at 30 frames per second. As a client of telemental health services, you decide 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 continue with 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. 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. My practice is part-time and I may not be available when you need crisis counseling. If you need more frequent contact than I am able to provide in our regular sessions, I can provide referrals to clinicians who can provide this service. In the case of an emergency, please call the Santa Clara County Crisis Line (000-000-0000), dial 911 or go to your local emergency room. A free 30-minute meeting is available prior to beginning counseling. You should evaluate this information our conversation along with your own opinions of whether you feel comfortable working with me. Counseling Therapy involves a significant large commitment of time, money and energy, so you should be very careful about the counselor therapist you select. If I offer traditional 50-minute appointments. The fee for a 50-minute session is $170.00. Mileage will be 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 these fees, I charge for additional services you have any questions about may need: Consultation reports are billed at the rate of $170/hour broken down into 10-minute increments. Legal proceedings that require my approach or procedures, we should discuss them whenever they arise. This agreement is for Counseling or Coaching. While counseling and coaching can work with issues such as identifying and reaching life goals, and changing the behaviors that aren’t working well for you, counseling/coaching is not intended to work through issues such as schizophrenia and suicidal behaviors. For issues such as these, you must see a Physician or Licensed Mental Health Professional in your location. By signing this agreement, you are agreeing that you understand the difference in these two functions and you participation will get appropriate professional help for mental health issues if necessary. Please feel free to ask questions at any time about your counselor’s/coach’s background, experience and professional orientationalso be billed.
Appears in 1 contract
Samples: Service Agreement
Counseling Services. Counseling Your first appointment (or more, in some cases) will involve an assessment of your needs. By the end of the assessment I will be able to offer you some first impressions of what your work may include and recommendation for getting help. One of the recommendations may be a psychotherapy. If so, I may or may not be able to provide you with psychotherapy, depending on your overall needs. If psychotherapy or any other recommendations suggested by me include things that I cannot provide, you will be given suggestions of where you might receive those services. Wherever you choose to obtain treatment or not, 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 within with the treating clinician. Therapy involves a large commitment of time, energy, and often money, so you should be very careful about the therapist you select. If you have questions about the procedures used or conclusions made by me, Xxxx X. Xxxxx, LPC, please discuss them wherever they arise. If your doubts persist, I will be happy to offer referrals to you with another mental health professional for a 2nd opinion. Psychotherapy is not easily described in general statements. It varies depending on the personality particular problems you are experiencing, the therapeutic methods used by your counselor, and the personalities of the counselor and the client, as well as the problems and challenges you bring forwardclients. There are many different different methods I counselors may use to deal with the problems that you want hope to address. Counseling Psychotherapy is not like a medical doctor visit. Instead, it requires calls for a very active effort effort on your part. In order for the counseling therapy to be most successful, successful you will need have to work on the areas we talk about things that are discussed both during our sessions your session and especially in between sessions. Counseling on your own Psychotherapy can have both benefits benefits and risks. Since counseling risks since therapy is often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, shame, frustration, loneliness loneliness, and helplessness. Counseling The changes you xxx in therapy may also affect your relationships in unexpected ways. Psychotherapy has also been shown to have benefits. Therapy often leads to better relationships, solutions to specific specific problems and significant significant reductions in feelings of distress, however, . But there are no guarantees of what you will experience. By signing this document, you agree to not hold Cara Damier liable or responsible for any results or outcomes of counseling or coaching and to also not seek out legal action against Xxxx Xxxxxx for any reason. Our first few sessions will involve an evaluation of your needs. By the end of the evaluation, I will be able to offer you some first impressions of what our work will entail and develop a treatment plan to follow should you decide to continue with counseling. You should evaluate this information along with your own opinions of whether you feel comfortable working with me. Counseling involves a significant commitment of time, money and energy, so you should be very careful about the counselor you select. If you have any questions about my approach or procedures, we should discuss them whenever they arise. This agreement is for Counseling or Coaching. While counseling and coaching can work with issues such as identifying and reaching life goals, and changing the behaviors that aren’t working well for you, counseling/coaching is not intended to work through issues such as schizophrenia and suicidal behaviors. For issues such as these, you must see a Physician or Licensed Mental Health Professional in your location. By signing this agreement, you are agreeing that you understand the difference in these two functions and you will get appropriate professional help for mental health issues if necessary. Please feel free to ask questions at any time about your counselor’s/coach’s background, experience and professional orientation.
Appears in 1 contract
Samples: Informed Consent for Psychotherapy Client Services Agreement
Counseling Services. Counseling 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 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 personality particular problems you are experiencing, the therapeutic methods used by your counselor, and the personalities of the counselor and the client, as well as the problems and challenges you bring forward. There are many different different methods I counselors may use to deal with the problems that you want hope to address. Counseling Psychotherapy is not like a medical doctor visit. Instead, it requires calls for a very active effort effort on your part. In order for the counseling therapy to be most successful, you will need have to work on the areas we talk about things that are discussed both during our your sessions and especially in between sessionson your own. Counseling Psychotherapy can have both benefits benefits and risks. Since counseling therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, shame, frustration, loneliness loneliness, and helplessness. Counseling 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 specific problems, and significant significant reductions in feelings of distress, however, . But there are no guarantees of what you will experience. By signing The initial assessment will last from one to two sessions. During this documenttime, 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 psychotherapy 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 not hold Cara Damier liable or responsible attend unless you provide advance notice of cancellation. If you need to cancel an appointment, it is your responsibility to contact us to cancel. 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 results returned check. We understand that there are unforeseeable circumstances like sick children or outcomes of counseling bad weather. Your appointment is important though, and your therapist is happy to contact you for a phone session or coaching and to also not seek out legal action against Xxxx Xxxxxx for any reason. Our first few sessions will involve an evaluation of your needs. By the end of the evaluation, I will be able to offer you some first impressions of what a session via our work will entail and develop a treatment plan to follow should you decide to continue with counseling. You should evaluate this information along with your own opinions of whether you feel comfortable working with me. Counseling involves a significant commitment of time, money and energy, HIPPA-compliant virtual therapy system so you should 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 very careful about the counselor you selectmade 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 cannot accommodate cancellations made after hours or on holidays to our main number as we do not accept voice mail. If you have any questions about my approach an appointment on a Monday or procedures, we should discuss them whenever they arise. This agreement is for Counseling or Coaching. While counseling and coaching can work with issues such as identifying and reaching life goals, and changing the behaviors that aren’t working well for you, counseling/coaching is not intended to work through issues such as schizophrenia and suicidal behaviors. For issues such as thesefirst day following a holiday, you must see make your change or cancellation the last business day before your appointment. • Cancellations with less than 24 hours notice will result in a Physician or Licensed Mental Health Professional in fee equal to the total amount of the missed session that will be collected at your locationnext appointment, or, if payment information is on file, it will be debited from your credit card. By signing this agreement• 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 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 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 agreeing 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 understand find out exactly what mental health services your insurance policy covers. You must pay your xxxx first, then contact your insurance company regarding reimbursement. We answer our main office number 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 difference in these two functions 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 get appropriate professional help be given the information for mental health issues another licensed therapist with whom you may schedule if necessary. Please feel free to ask questions at any time about you need an appointment during your counselor’s/coachtherapist’s background, experience and professional orientationabsence.
Appears in 1 contract
Samples: Client Services Agreement
Counseling Services. Counseling 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, APC 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 APC 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 therapist you select. If you have questions about the procedures used or conclusions made by your counselor at APC, 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 personality particular problems you are experiencing, the therapeutic methods used by your counselor, and the personalities of the counselor and the client, as well as the problems and challenges you bring forward. There are many different different methods I counselors may use to deal with the problems that you want hope to address. Counseling Psychotherapy is not like a medical doctor visit. Instead, it requires calls for a very active effort effort on your part. In order for the counseling therapy to be most successful, you will need have to work on the areas we talk about things that are discussed both during our your sessions and especially in between sessionson your own. Counseling Psychotherapy can have both benefits benefits and risks. Since counseling therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, shame, frustration, loneliness loneliness, and helplessness. Counseling 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 specific problems, and significant significant reductions in feelings of distress, however, . But there are no guarantees of what you will experience. By signing this document, you agree to not hold Cara Damier liable or responsible for any results or outcomes of counseling or coaching and to also not seek out legal action against Xxxx Xxxxxx for any reason. Our first few sessions will involve an evaluation of your needs. By the end of the evaluation, I will be able to offer you some first impressions of what our work will entail and develop a treatment plan to follow should you decide to continue with counseling. You should evaluate this information along with your own opinions of whether you feel comfortable working with me. Counseling involves a significant commitment of time, money and energy, so you should be very careful about the counselor you select. If you have any questions about my approach or procedures, we should discuss them whenever they arise. This agreement is for Counseling or Coaching. While counseling and coaching can work with issues such as identifying and reaching life goals, and changing the behaviors that aren’t working well for you, counseling/coaching is not intended to work through issues such as schizophrenia and suicidal behaviors. For issues such as these, you must see a Physician or Licensed Mental Health Professional in your location. By signing this agreement, you are agreeing that you understand the difference in these two functions and you will get appropriate professional help for mental health issues if necessary. Please feel free to ask questions at any time about your counselor’s/coach’s background, experience and professional orientation.
Appears in 1 contract
Samples: Informed Consent Agreement
Counseling Services. Counseling Your first appointment (or more, in some cases) will involve an assessment of your needs. By the end of the assessment Xxxx Xxxxxx 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, Xxxx Xxxxxx 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 Xxxx Xxxxxx Counseling, Inc. 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 Xxxx Xxxxxx. Therapy involves a large commitment of time, energy, and often money, so you should be very careful about the therapist you select. If you have questions about the procedures used or conclusions made by Xxxx Xxxxxx, 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 personality particular problems you are experiencing, the therapeutic methods used by your counselor, and the personalities of the counselor and the client, as well as the problems and challenges you bring forward. There are many different different methods I counselors may use to deal with the problems that you want hope to address. Counseling Psychotherapy is not like a medical doctor visit. Instead, it requires calls for a very active effort effort on your part. In order for the counseling therapy to be most successful, you will need have to work on the areas we talk about things that are discussed both during our your sessions and especially in between sessionson your own. Counseling Psychotherapy can have both benefits benefits and risks. Since counseling therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, shame, frustration, loneliness loneliness, and helplessness. Counseling 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 specific problems, and significant significant reductions in feelings of distress, however, . But there are no guarantees of what you will experience. By signing The initial assessment will last from one to two sessions. During this documenttime, you and Xxxx Xxxxxx can both decide if she is the best person to provide the services you need in order to meet your treatment goals. If psychotherapy is begun it is typical to schedule one meeting per week at a time you each agree on. Once an appointment is scheduled, you will be expected to not hold Cara Damier liable or responsible attend unless you provide advance notice of cancellation. If you need to cancel an appointment, it is your responsibility to contact us to cancel. Fees will be collected when services are rendered. The fee per 50 minute counseling session is $110, and will be adjusted accordingly when 50 minutes is exceeded. In addition to therapy services fees may include 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 results returned check. We understand that there are unforeseeable circumstances like sick children or outcomes of counseling or coaching bad weather. Your appointment is important though, and to also not seek out legal action against Xxxx Xxxxxx is happy to contact you for any reason. Our first few sessions will involve an evaluation of your needs. By the end of the evaluation, I will be able to offer you some first impressions of what a phone session or a session via our work will entail and develop a treatment plan to follow should you decide to continue with counseling. You should evaluate this information along with your own opinions of whether you feel comfortable working with me. Counseling involves a significant commitment of time, money and energy, HIPPA-compliant virtual therapy system so you should 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 very careful about the counselor you selectmade within 24 hours of session time. ● We cannot accommodate cancellations made via email as we do not monitor email on a regular basis. ● We cannot accommodate cancellations made after hours or on holidays. If you have any questions about my approach an appointment on a Monday or procedures, we should discuss them whenever they arise. This agreement is for Counseling or Coaching. While counseling and coaching can work with issues such as identifying and reaching life goals, and changing the behaviors that aren’t working well for you, counseling/coaching is not intended to work through issues such as schizophrenia and suicidal behaviors. For issues such as thesefirst day following a holiday, you must see make your change or cancellation the last business day before your appointment. ● Cancellations with less than 24 hours’ notice will result in a Physician or Licensed Mental Health Professional $75 fee 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, a pre-paid retainer will be required 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 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. You (not your locationinsurance company) are responsible for full payment of fees. By signing this agreement, you are agreeing It is very important that you understand find out exactly what mental health services your insurance policy covers. You must pay your xxxx first, then contact your insurance company regarding reimbursement. You can contact our main office number (281-350-1277) 24 hours a day/7 days a week. If an administrative assistant or Xxxx Xxxxxx, does not answer, please leave a message on the difference internal/secure voicemail system. Messages are typically returned within 24 hours during the business week, or 48 hours for messages left on the weekend. You may have your counselor’s cell phone number in these two functions 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). ● Xxxx Xxxxxx Counseling, Inc., may not acknowledge or return emails or text messages that are not administrative. This includes emergency texts and emails. ● If Xxxx Xxxxxx leaves for an extended period of time you will get appropriate professional help be given the information for mental health issues another licensed therapist with whom you may schedule if necessary. Please feel free to ask questions at any time about you need an appointment during your counselor’s/coachtherapist’s background, experience and professional orientationabsence.
Appears in 1 contract
Samples: Client Service Agreement
Counseling Services. Counseling Your first appointment (or more, in some cases) will involve an assessment of your needs. By the end of the assessment 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 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 me, please discuss them whenever they arise. If your doubts persist, 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 personality particular problems you are experiencing, the therapeutic methods used by your counselor, and the personalities of the counselor and the client, as well as the problems and challenges you bring forward. There are many different different methods I counselors may use to deal with the problems that you want hope to address. Counseling Psychotherapy is not like a medical doctor visit. Instead, it requires calls for a very active effort effort on your part. In order for the counseling therapy to be most successful, you will need have to work on the areas we talk about things that are discussed both during our your sessions and especially in between sessionson your own. Counseling Psychotherapy can have both benefits benefits and risks. Since counseling therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, shame, frustration, loneliness loneliness, and helplessness. Counseling 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 specific problems, and significant significant reductions in feelings of distress, however, . But there are no guarantees of what you will experience. By signing The initial assessment will last from one to four sessions. During this documenttime, you agree and I can both decide if I am is the best person to not hold Cara Damier liable or responsible for any results or outcomes of counseling or coaching and provide the services you need in order to also not seek out legal action against Xxxx Xxxxxx for any reasonmeet your treatment goals. Our first few sessions will involve an evaluation of your needs. By the end of the evaluationIf you choose to begin psychotherapy, I will usually schedule one meeting at a time agree upon. Once an appointment is scheduled, you will be able expected to offer attend unless you some first impressions provide advance notice of what our work cancelation. If you need to cancel an appointment, it is your responsibility to contact me to cancel. Fees will entail be collected when services are rendered. In addition to therapy services fees may include assessment administration, scoring, and develop 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. I understand that there are unforeseeable circumstances like sick children or bad weather. Your appointment is important though, and I am happy to contact you for a treatment plan to follow should you decide to continue with counseling. You should evaluate this information along with your own opinions of whether you feel comfortable working with me. Counseling involves phone session or a significant commitment of time, money and energy, session via a HIPAA-compliant virtual therapy system so you should don't need to leave your sick child or worry about traffic and weather. As long as you are in a confidential location, I can help you keep your regularly scheduled appointment. If you still must change or cancel your counseling appointment, please know: • Cancelations must be very careful about the counselor you selectmade within 48 hours of session time 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 do not take cancelations via email. Emails from our scheduling software are automated and clearly marked ‘no reply.’ Replies to our email are not monitored. • I may not accommodate cancelations made after hours or on holidays to our main number as I cannot check voice mail regularly. If you have any questions about my approach an appointment on a Monday or procedures, we should discuss them whenever they arise. This agreement is for Counseling or Coaching. While counseling and coaching can work with issues such as identifying and reaching life goals, and changing the behaviors that aren’t working well for you, counseling/coaching is not intended to work through issues such as schizophrenia and suicidal behaviors. For issues such as thesefirst day following a holiday, you must see make your change or cancelation the last business day before your appointment. • Cancelations with less than 24 hours’ notice will result in a Physician or Licensed Mental Health Professional in fee equal to the total amount of the missed session that will be collected at your locationnext appointment, or, if payment information is on file, it will be debited from your credit card. By signing this agreement• *After two no-shows/late cancelations, 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/cancelations. Any money left over from retainer after no-show fee is deducted will be refunded. • 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 agreeing 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 understand find out exactly what mental health services your insurance policy covers. You must pay your xxxx first, then contact your insurance company regarding reimbursement. I answer the difference main office number 9:00 AM – 5:00 PM Monday through Friday (except holidays). Email, and text messaging are not secure mediums in these two functions terms of privacy and confidentiality so my policy is: • I do not provide therapy/counseling via email or text messaging. • I may not acknowledge or return emails or text 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 service. • If I leave for an extended period of time you will get appropriate professional help be given the information for mental health issues another licensed therapist with whom you may schedule if necessaryyou need an appointment during my absence. Please feel free Keep in mind you will need to ask questions at any time about your counselor’s/coach’s backgroundfill out other paperwork. • Social media is not a means of communication. If you find me on social media, experience and professional orientationI will not communicate with you.
Appears in 1 contract
Samples: Client Services Agreement
Counseling Services. Counseling People choose to participate in counseling for a variety of reasons. For most, the purpose of counseling is not easily described 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 general statements. It varies counseling can be different, depending on factors such as the personality personalities of the counselor client and therapist, the mode of counseling techniques that the therapist utilizes, the issue(s) being addressed, and the client, as well as amount of effort that the problems and challenges you bring forwardclient puts forth. There are many different methods I may use to deal Your initial sessions with the problems you want to address. Encourage Counseling is not like a medical doctor visit. Instead, it requires a very active effort on your part. In order for the counseling to be most successful, you will need to work on the areas we talk about both during our sessions and especially in between sessions. Counseling can have both benefits and risks. Since counseling often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness and helplessness. Counseling often leads to better relationships, solutions to specific problems and significant reductions in feelings of distress, however, there are no guarantees of what you will experience. By signing this document, you agree to not hold Cara Damier liable or responsible for any results or outcomes of counseling or coaching and to also not seek out legal action against Xxxx Xxxxxx for any reason. Our first few sessions Services will involve an evaluation of your needs. By the end of the evaluation, I your therapist will be able to offer offer you some first first impressions of what our your work will entail include and develop a treatment plan to follow should follow, if you decide to continue with counselingtherapy. You should evaluate this information along with your own opinions of whether you feel comfortable working with meus. Counseling Therapy involves a significant commitment of time, money money, and energy, so you should be very careful about the counselor therapist you select. If you have any questions about my approach or our procedures, we you should discuss them with your therapist whenever they arise. If you wish, we will willingly provide you with referrals to other mental health 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. Following the assessment period, which is typically 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 is important to note that if you are late to your appointment, your session will still end at the originally scheduled time. It should be noted that therapy can have benefits, as well as potential risks. Since therapy oftentimes involves discussing difficult aspects of your life, you may experience uncomfortable feelings such as sadness, guilt, anger, frustration, loneliness, and helplessness. Making changes in your beliefs or behaviors can be anxiety provoking, and can be disruptive to your current relationships. However, therapy has also been shown to have many benefits. For example, therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress. Of course, every individual’s experience is different and there are no guarantees of what you will experience. 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 be the one who decides when therapy will end, which usually occurs once you and your therapist agree that you have met your treatment goals. However, there are a few exceptions. One such exception is if your therapist does not believe that he/she is professionally able to meet your needs. This agreement 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 have. In such a situation your therapist will refer you to another therapist who may be able to meet your counseling needs. Professional Training and Approach to Therapy Your therapist through Encourage Counseling Services, Xxxxxxx Xxxxxxx, holds a Master’s of Arts Degree in Counseling, earned in 2010 at MidAmerica Nazarene University, in Olathe, Kansas. He is a Licensed Professional Counselor (LPC) in the state of Missouri and a Nationally Certified Counselor (NCC). Xxxxx has a significant amount of experience in working with clients in the areas of trauma, anxiety, depression, grief, behavioral issues, as well as extreme mental health cases. He utilizes a Cognitive Behavioral approach in his work, which is a philosophy of psychotherapy that evaluates the relationship between thoughts and emotions as behavior change. Xxxxx also uses a variety of techniques in therapy, depending on what will work best for the client. Xxxxx’s overall emphasis is the therapeutic relationship he builds with his clients. He believes it’s in this relationship that real, authentic, lasting change can occur. Contacting Your Therapist If you need to speak with your therapist outside of your scheduled appointment time, you may leave a voicemail message with your contact information and your call will be returned within 48 hours. Your therapist will make every effort to return your call on the same day, with the exception of weekends and holidays. Encourage Counseling Services is not an emergency provider. Thus, in an emergency situation you are instructed to call 9-1-1 or Coachingthe 24-hour Emergency Service Crisis Line (0-000-000-0000). In addition, in the unlikely event that your therapist is unable to provide ongoing services, Xxx Xxxxxxx, MS, LPC (816-223-6376) will provide those services or will refer you to the appropriate resource. If you elect to communicate with your therapist by email, please be aware that email is not completely confidential. All emails are retained in the logs of your or your therapist’s internet service providers. While under normal circumstances these logs are not viewed, they are, in theory, available to be read by the system administrator(s) of the internet service provider. Any email that your therapist receives from you, and any responses that your therapist sends to you, will be printed out and kept in your treatment record. Confidentiality With the exception of the specific situations described below, you have the absolute right to the confidentiality of your therapy. This confidentiality is protected under the provisions of the federal Health Insurance Portability and Accountability Act (HIPAA). For detailed information regarding your rights regarding the protection of your Personal Health Information (PHI) please refer to the attached Notice of Privacy Practices, which reports when PHI may be used for treatment, payment, and health care options. By initialing you are indicating that you have also been provided with and read a copy of the Notice of Privacy Practices. In most situations, your therapist can only release information about your treatment to others if you sign a written authorization form that meets certain legal requirements imposed by HIPAA. This includes permission to inform your primary care physician and/or your psychiatrist that he/she is providing counseling services to you. It may be helpful for your therapist to confer with your medical professional with regard to your psychological treatment or to discuss any medical problems for which you are receiving treatment. If you agree to have your therapist inform your primary care physician and/or psychiatrist of the counseling services you are receiving, please indicate as such in the appropriate check box below, and coaching can provide his/her name and contact information. Physician Phone There are other situations that require only that you provide written, advance consent. Your signature on this agreement provides consent for those activities, as follows: Your therapist may occasionally find it helpful to consult other health and mental health professionals about a case. During a consultation, your therapist makes every effort to avoid revealing the identity of the client. The other professionals are also legally bound to keep the information confidential. All consultations will be noted in your clinical record. If your insurance company is paying for a portion of or all of your counseling services, records containing your mental health diagnosis and dates of service must be provided to them. If your therapist has reasonable cause to suspect that a child or an elderly or disabled adult has been or may be subjected to abuse or neglect, or observes such persons being subjected to such conditions or circumstances, the law requires that your therapist file a report with appropriate authorities. If your therapist believes that you are in imminent danger of harming yourself, your therapist may legally break confidentiality and take protective action. These actions may include initiating hospitalization, contacting the police, and/or contacting your family. If your therapist has reason to believe that you will harm another person, your therapist must attempt to inform that person and warn him/her of your intentions. Your therapist must also contact the police and ask them to protect your intended victim. If you are involved in a court proceeding and a request is made for information concerning your diagnosis and treatment, such information is protected by the above listed confidentiality laws. Your therapist cannot provide any information without your or your legal representative’s written authorization, or a court order. If you are involved in or contemplating litigation, you should consult with your attorney to determine whether a court would be likely to order your therapist to disclose information. Professional Records Your therapist will keep professional records of your therapy sessions and the therapeutic services that you receive, which will be maintained in a secure location that cannot be accessed by anyone else. These records will include information about your reasons for seeking therapy, your diagnosis, the goals that are set for treatment, your progress toward those goals, your medical, social, and treatment history, and any past treatment records that your therapist receives from other providers. Your clinical record will also include reports of any professional consultations, your billing records, and any reports that have been sent to anyone, including reports to your insurance carrier (if applicable). In addition, your clinical record will include information regarding the dates that therapy sessions occurred, interventions that were utilized, and topics that were discussed. You have the right to a copy of your file at any time, giving your therapist adequate time to make a copy for you. However, since psychological records are usually written in terminology that is difficult to understand, it is encouraged that you schedule an appointment with your therapist to review your records under his/her supervision and care. This service is provided free of charge. You also have the right to request that your therapist correct any errors in your file. In addition, you have the right to request that your therapist make a copy of your file available to any other health care provider or agency, upon your written request. Your records will be kept for seven years past the date of service; after that time they are destroyed and unavailable. In the event of your therapist’s death or incapacitation, your records will be stored by another practitioner for seven years, and will be available to you during that time. In such an event, Xxx Xxxxxxx, LPC (816-781-4414) has agreed to store such records. Professional Fees / Payments In addition to weekly appointments, your therapist will charge this amount for other professional services you may need, though the hourly cost will be broken down for work lasting for shorter periods of time than one hour. Other services include report writing, telephone conversations lasting longer than 15 minutes, consulting with issues other professionals with your permission, preparation of records or treatment summaries, and the time spent performing any other service you may request of your therapist. If you become involved in legal proceedings that require your therapist’s participation, you will be expected to pay for all of your therapist’s professional time, including preparation and transportation costs, even if he/she is called to testify by another party. Fees for legal proceedings are $80 per hour and will be requested in advance of any work performed. Once an appointment hour is scheduled, you will be expected to pay the assigned fee unless you provide 24-hours advance notice of cancellation, or unless you were unable to attend due to circumstances beyond your control (e.g., illness or poor weather conditions). Otherwise, you will be responsible for paying for the missed session at your next scheduled session. (It should be noted that insurance companies typically do not reimburse for cancelled sessions, so you are responsible for payment.) Three sessions without payment will cancel future sessions until the account is paid in full. In addition, if your account should remain unpaid for more than 90 days, you will not be able to receive services from Encourage Counseling Services until your account is paid for with the agreed upon terms or you will be referred to seek alternative mental health assistance. If your account has not been paid for more than 90 days and arrangements for payment have not been agreed upon, Encourage Counseling Services has the option of using legal means to secure the payment. This may involve hiring a collection agency, notification of the credit bureau, or going through small claims court which will require us to disclose otherwise confidential information. In most collection situations, the only information released regarding a client’s treatment is his/her name, the nature of services provided, and the amount due. If such legal action is necessary, its costs will be included in the claim. Insurance Coverage If you plan to utilize your health insurance for your counseling services, it is important that you discover exactly what mental health services your insurance policy covers, and obtain preauthorization as necessary. Your therapist will assist you in receiving the benefits to which you are entitled; you are responsible for providing appropriate information, such as identifying your complete insurance identification information and reaching life goalsany preauthorization codes, to your therapist in order for him/her to do so. It should also be noted that insurance companies typically do not accept bills from therapists unless they are on their preferred provider list. If your therapist is not a preferred provider for your particular health insurance company, you may still choose to submit claims to obtain reimbursement for your counseling services. However, in such cases you are responsible for full payment of fees and changing submitting claims for reimbursement of fees. If you choose to have your counseling services paid for in full or in part by your insurance company, there are typically additional limitations to your rights as a client imposed by the behaviors that aren’t working well for contract of the managed care firm. These may include their decision to limit the number of sessions available to you, counseling/coaching is not intended to work through issues such as schizophrenia and suicidal behaviorsdecide the time period within which you must complete your therapy, or to require you to use medication if their reviewing professional deems it appropriate. For issues such as these, Your managed care firm may also decide that you must see another therapist in their network rather than your therapist through Encourage Counseling Services, if he/she is not on their list of providers. You should also be aware that your contract with your health insurance company requires that your therapist provide information relevant to the services that you are provided. Your therapist is required to provide a Physician clinical mental health diagnosis. Your therapist may be required to provide additional clinical information such as treatment plans or Licensed Mental Health Professional in summaries, or copies of your locationentire clinical record. In such situations, your therapist will make every effort to release only the minimum information about you that is necessary for the purpose requested. This information will become part of the insurance company files. Though all insurance companies claim to keep such information confidential, your therapist has no control over what is done with the information once it is released. Your therapist will provide you with a copy of any report submitted, if you request it. By signing this agreement, you are agreeing agree that your therapist can provide requested information to your carrier. If prior to receiving services you understand choose not to use your insurance, you have the difference in these two functions and you will get appropriate professional help right to pay for mental health issues if necessary. Please feel free your counseling services yourself to ask questions at any time about your counselor’s/coach’s background, experience and professional orientationavoid the problems described above unless prohibited by contract.
Appears in 1 contract
Samples: Counseling Services Agreement
Counseling Services. Counseling 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 personality particular problems you are experiencing, the therapeutic methods used by your counselor, and the personalities of the counselor and the client, as well as the problems and challenges you bring forward. There are many different different methods I counselors may use to deal with the problems that you want hope to address. Counseling Psychotherapy is not like a medical doctor visit. Instead, it requires calls for a very active effort effort on your part. In order for the counseling therapy to be most successful, you will need have to work on the areas we talk about things that are discussed both during our your sessions and especially in between sessionson your own. Counseling Psychotherapy can have both benefits benefits and risks. Since counseling therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, shame, frustration, loneliness loneliness, and helplessness. Counseling 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 specific problems, and significant significant reductions in feelings of distress, however, . But there are no guarantees of what you will experience. By signing The initial assessment will last from one to four sessions. During this documenttime, 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 not hold Cara Damier liable or responsible attend unless you provide advance notice of cancellation. If you need to cancel an appointment, it is your responsibility to contact us to cancel. 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 results returned check. We understand that there are unforeseeable circumstances like sick children or outcomes of counseling bad weather. Your appointment is important though, and your therapist is happy to contact you for a phone session or coaching and to also not seek out legal action against Xxxx Xxxxxx for any reason. Our first few sessions will involve an evaluation of your needs. By the end of the evaluation, I will be able to offer you some first impressions of what a session via our work will entail and develop a treatment plan to follow should you decide to continue with counseling. You should evaluate this information along with your own opinions of whether you feel comfortable working with me. Counseling involves a significant commitment of time, money and energy, HIPPA-compliant virtual therapy system so you should 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 very careful about the counselor you selectmade 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 any questions about my approach an appointment on a Monday or procedures, we should discuss them whenever they arise. This agreement is for Counseling or Coaching. While counseling and coaching can work with issues such as identifying and reaching life goals, and changing the behaviors that aren’t working well for you, counseling/coaching is not intended to work through issues such as schizophrenia and suicidal behaviors. For issues such as thesefirst day following a holiday, you must see make your change or cancellation the last business day before your appointment. • Cancellations with less than 24 hours’ notice will result in a Physician or Licensed Mental Health Professional in fee equal to the total amount of the missed session that will be collected at your locationnext appointment, or, if payment information is on file, it will be debited from your credit card. By signing this agreement• *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 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 agreeing 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 understand find out exactly what mental health services your insurance policy covers. You must pay your xxxx first, then contact your insurance company regarding reimbursement. 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 difference in these two functions 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 get appropriate professional help be given the information for mental health issues another licensed therapist with whom you may schedule if necessaryyou need an appointment during your therapist’s absence. Please feel free You may need to ask questions at any time about your counselor’s/coach’s background, experience and professional orientationfill out other paperwork if therapist is in another practice.
Appears in 1 contract
Samples: Client Services Agreement
