Subpoena of a court. If you become involved in a court case or proceeding, you can prevent me from testifying in court about what you have told me. This is called “privilege’ and it is your choice to prevent me from testifying or allow me to do so. It is conceivable, however, that in some situations a judge or a court may require me to testify regardless of your non-consent. Vulnerable Adult and Position of Authority: I may make a report to the appropriate licensure board or governing authority if a person responsible for the care of vulnerable people (a medical or mental health professional, lawyer, or pastor, for example) is being sexually inappropriate with those under his/her care. I will make a determination about reporting on a case by case basis. Finally, I may occasionally find it helpful to consult other professionals about a case. During a consultation, I make every effort to avoid revealing the identity of my patient. The consultant is also legally bound to keep the information confidential. If you don’t object, I will not tell you about these consultations unless I feel that it is important to our work together. Fees and Cancellation Policies Our first few sessions are evaluation times for both of us. During this time, we can both decide if I am the best person to provide the services you need in order to meet your treatment goals. Standard fee applies for these sessions. If psychotherapy is begun, we will schedule sessions at the 50-minute session per week at a time we agree on. My fee for an individual 50-minute session is $105 and for a family or couple session is $115. Full payment is due at the end of session, and may be paid by cash, checks written to Center for Healing, or by credit/debit card. Unless otherwise agreed upon, if fees are not paid for two sessions, no further sessions will be scheduled until account is brought up to date. Once an appointment is scheduled, you will be expected to pay for it unless you provide 24 hours advance notice of cancellation, or unless we both agree that you were unable to attend due to circumstances beyond your control. Please provide a debit/credit card number below the signature line in this document. It is my desire that no person be denied counseling services due to a lack of financial resources. If you have a need, please speak with me during your first counseling appointment. I have a limited number of slots available for clients on a sliding scale basis and I am happy to work with you to make therapy possible fo...
Subpoena of a court. If you become involved in a court case or proceeding, you can prevent me from testifying in court about what you have told me. This is called “privilege’ and it is your choice to prevent me from testifying or allow me to do so. It is conceivable, however, that in some situations a judge or a court may require me to testify regardless of your non-consent. Finally, I may occasionally find it helpful to consult other professionals about a case. During a consultation, I make every effort to avoid revealing the identity of my patient. The consultant is also legally bound to keep the information confidential. If you don’t object, I will not tell you about these consultations unless I feel that it is important to our work together.
