Common use of Telephone and Emergency Procedures Clause in Contracts

Telephone and Emergency Procedures. If you need to contact the psychotherapist between sessions, please leave a message on the answering machine (000) 000-0000 and your call will be returned as soon as possible. The psychotherapist checks her messages a few times a day (but never during the nighttime), unless she is out of town. The psychotherapist checks the messages less frequently on weekends and holidays. If an emergency situation arises, please indicate it clearly in your message. If you need to talk to someone right away, you can call the Xxxx Xxxxxx Center at 0000 Xxxxx Xxx., Ft. Xxxxx, FL 33905, the 24-hour crisis line (000) 000-0000, the Police (911), or the 24-hour psychiatric emergency number, (000) 000-0000. Payments and insurance reimbursement Clients are expected to pay the standard fee of $120 per 50 - minute session (or $150 for psychologists fee) at the end of each session unless other arrangements have been made. Telephone conversations, site visits, report writing and reading, consultation with other professionals, release of information, reading records, longer sessions, travel time, and so forth, will be charged at the same rate, unless indicated and agreed otherwise. Please notify the psychotherapist if any problem arises during the course of therapy regarding your ability to make timely payments. Not all issues/conditions/problems that are the focus of psychotherapy are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. A regular credit card will be taken over the phone before the first therapy session. 50% of the no show fee will be charged to the credit card to hold the first appointment or use towards a future missed session. If no session is missed, you will receive a full reimbursement for the amount held. The process of therapy/ evaluation Participation in therapy can result in a number of benefits to you, including improving interpersonal relationships and resolution of the specific concerns that led you to seek therapy. Working toward these benefits, however, requires effort on your part. Psychotherapy requires your very active involvement, honesty, and openness in order to change your thoughts, feelings, and/or behavior. The psychotherapist will ask for your feedback and views on your therapy, its progress, and other aspects of the therapy and will expect you to respond openly and honestly. Sometimes more than one approach can be helpful in dealing with a certain situation. During evaluation or therapy, remembering or talking about unpleasant events, feelings, or thoughts can result in your experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, and so forth, or experiencing anxiety, depression, insomnia, and so forth. The psychotherapist may challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations that can cause you to feel very upset, angry, depressed, challenged, or disappointed. Attempting to resolve issues that brought you to therapy in the first place, such as personal or interpersonal relationships, may result in changes that were not originally intended. Psychotherapy may result in decisions about changing behaviors, employment, substance use, schooling, housing, or relationships. Sometimes a decision that is positive for one family member is viewed quite negatively by another family member. Change will sometimes be easy and swift, but more often it will be slow and even frustrating. There is no guarantee that psychotherapy will yield positive or intended results. During the course of therapy, the psychotherapist is likely to draw on various psychological approaches according, in part, to the problem that is being treated and his/her assessment of what will best benefit you. These approaches include behavioral, cognitive-behavioral, psychodynamic, existential, system/family, developmental (adult, child, family), or psychoeducational. Discussion of treatment plan Within a reasonable period of time after the initiation of treatment, the psychotherapist will discuss with you (client) her working understanding of the problem, treatment plan, therapeutic objectives, and view of the possible outcomes of treatment. If you have any unanswered questions about any of the procedures used in the course of your therapy, their possible risks, the psychotherapist’s expertise in employing them, or about the treatment plan, please ask and you will be answered fully. You also have the right to ask about other treatments for your condition and their risks and benefits. If you could benefit from any treatment that the psychotherapist does not provide, he has an ethical obligation to assist you in obtaining those treatments.

Telephone and Emergency Procedures. If you need to contact the psychotherapist Xx. Xxxxxxxxx between sessions, please leave a message on the answering machine voice mail service (000) 000-0000 and your call will be returned as soon as possible. The psychotherapist Please call from 9:00a.m. to 8:00p.m. for non-emergency calls. Call between 8:00p.m. and 9:00a.m. only if it is urgent. Xx. Xxxxxxxxx checks her his messages a few several times a day (but never during the nighttime)week. Please leave your name, unless she is out the date, and your telephone number where Xx. Xxxxxxxxx can reach you, even if you think Xx. Xxxxxxxxx already has it. In case of town. The psychotherapist checks the messages less frequently on weekends and holidays. If an emergency situation arisesemergency, please indicate it clearly in your messagemessage and Xx. Xxxxxxxxx will call you back as soon as he is able to. If you need to talk to someone right away, you can please call the Xxxx Xxxxxx Center at 0000 Xxxxx Xxx., Ft. Xxxxx, FL 33905, the 24-24 hour crisis line (000) 000-0000, the Police (911), or the 24-24 hour psychiatric emergency number, (000) 000-0000Psychiatric Emergency. Payments Payment and insurance reimbursement Insurance Reimbursement: Clients are expected to pay the agreed upon fee, which may be the full fee, a sliding scale fee, or in insurance cases, a co-payment. The standard fee of is $120 220 per 50 - 60-minute session (or $150 for psychologists fee) session, which should be paid at the end of each session session, unless other arrangements have been made. Telephone conversations, site visits, report writing and reading, consultation with other professionals, release of information, reading records, longer sessions, travel time, and so forthetc... , will may be charged at the same rate, unless indicated and agreed otherwise. Please notify the psychotherapist Xx. Xxxxxxxxx if any problem arises during the course of therapy regarding your ability to make timely payments. Please remember Professional services are rendered and charged to the clients and not to the insurance company. Xx. Xxxxxxxxx'x Billing Service will submit your bill to your insurance company at least twice a month. Not all issues/conditions/problems that which are the focus of psychotherapy are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. A regular credit card will be taken over Should insurance not cover visits, full payment is due for completed visits. Payment for visits is ultimately the phone before the first therapy session. 50% responsibility of the no show fee will be charged to the credit card to hold the first appointment or use towards a future missed session. If no session is missed, you will receive a full reimbursement for the amount held. The process of therapy/ evaluation Participation in therapy can result in a number of benefits to you, including improving interpersonal relationships and resolution of the specific concerns that led you to seek therapy. Working toward these benefits, however, requires effort on your part. Psychotherapy requires your very active involvement, honesty, and openness in order to change your thoughts, feelings, and/or behavior. The psychotherapist will ask for your feedback and views on your therapy, its progress, and other aspects of the therapy and will expect you to respond openly and honestly. Sometimes more than one approach can be helpful in dealing with a certain situation. During evaluation or therapy, remembering or talking about unpleasant events, feelings, or thoughts can result in your experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, and so forth, or experiencing anxiety, depression, insomnia, and so forth. The psychotherapist may challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations that can cause you to feel very upset, angry, depressed, challenged, or disappointed. Attempting to resolve issues that brought you to therapy in the first place, such as personal or interpersonal relationships, may result in changes that were not originally intended. Psychotherapy may result in decisions about changing behaviors, employment, substance use, schooling, housing, or relationships. Sometimes a decision that is positive for one family member is viewed quite negatively by another family member. Change will sometimes be easy and swift, but more often it will be slow and even frustrating. There is no guarantee that psychotherapy will yield positive or intended results. During the course of therapy, the psychotherapist is likely to draw on various psychological approaches according, in part, to the problem that is being treated and his/her assessment of what will best benefit you. These approaches include behavioral, cognitive-behavioral, psychodynamic, existential, system/family, developmental (adult, child, family), or psychoeducational. Discussion of treatment plan Within a reasonable period of time after the initiation of treatment, the psychotherapist will discuss with you (client) her working understanding of the problem, treatment plan, therapeutic objectives, and view of the possible outcomes of treatment. If you have any unanswered questions about any of the procedures used in the course of your therapy, their possible risks, the psychotherapist’s expertise in employing them, or about the treatment plan, please ask and you will be answered fully. You also have the right to ask about other treatments for your condition and their risks and benefits. If you could benefit from any treatment that the psychotherapist does not provide, he has an ethical obligation to assist you in obtaining those treatments.

Telephone and Emergency Procedures. If you need to contact the psychotherapist between sessions, please leave a message on the answering machine (000) 000-0000 and your call will be returned as soon as possible. The psychotherapist checks her messages a few times a day (but never during the nighttime), unless she is out of town. The psychotherapist checks the messages less frequently on weekends and holidays. If an emergency situation arises, please indicate it clearly in your message. If you need to talk to someone right away, you can call the Xxxx Xxxxxx Center at 0000 Xxxxx Xxx., Ft. Xxxxx, FL 33905, the 24-hour crisis line (000) 000-0000, the Police (911), or the 24-hour psychiatric emergency number, (000) 000-0000. Payments and insurance reimbursement Clients are expected to pay the standard fee of $120 per 50 - minute session (or $150 for psychologists fee) at the end of each session unless other arrangements have been made. Telephone conversations, site visits, report writing and reading, consultation with other professionals, release of information, reading records, longer sessions, travel time, and so forth, will be charged at the same rate, unless indicated and agreed otherwise. Please notify the psychotherapist if any problem arises during the course of therapy regarding your ability to make timely payments. Not all issues/conditions/problems that are the focus of psychotherapy are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. A regular credit card will be taken over the phone before the first therapy session. 50% of the no show fee will be charged to the credit card to hold the first appointment or use towards a future missed session. If no session is missed, you will receive a full reimbursement for the amount held. The process Waiting room policy If your child is under the age of therapy/ evaluation Participation in therapy can result in a number of benefits to you, including improving interpersonal relationships and resolution of the specific concerns that led you to seek therapy. Working toward these benefits, however, requires effort on your part. Psychotherapy requires your very active involvement, honesty, and openness in order to change your thoughts, feelings, and/or behavior. The psychotherapist will ask 13 who is being dropped off for your feedback and views on your therapy, its progress, and other aspects of the therapy and will expect you to respond openly and honestly. Sometimes more than one approach can be helpful in dealing with a certain situation. During evaluation or therapy, remembering or talking about unpleasant events, feelings, or thoughts can result in your experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, and so forth, or experiencing anxiety, depression, insomnia, and so forth. The psychotherapist may challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations that can cause you to feel very upset, angry, depressed, challenged, or disappointed. Attempting to resolve issues that brought you to therapy in the first place, such as personal or interpersonal relationships, may result in changes that were not originally intended. Psychotherapy may result in decisions about changing behaviors, employment, substance use, schooling, housing, or relationships. Sometimes a decision that is positive for one family member is viewed quite negatively by another family member. Change will sometimes be easy and swift, but more often it will be slow and even frustrating. There is no guarantee that psychotherapy will yield positive or intended results. During the course of therapy, the psychotherapist is likely to draw on various psychological approaches according, in part, to the problem that is being treated and his/her assessment of what will best benefit you. These approaches include behavioral, cognitive-behavioral, psychodynamic, existential, system/family, developmental (adult, child, family), or psychoeducational. Discussion of treatment plan Within a reasonable period of time after the initiation of treatment, the psychotherapist will discuss with you (client) her working understanding of the problem, treatment plan, therapeutic objectives, and view of the possible outcomes of treatment. If you child must have any unanswered questions about any of the procedures used an adult present in the course of your waiting room until the therapist has taken the child back for therapy. The child must be picked up by an adult at the session ending time in the waiting room, their possible risks, the psychotherapist’s expertise in employing them, or about the treatment plan, please ask and you will be answered fully. You also unless other arrangements have the right to ask about other treatments for your condition and their risks and benefits. If you could benefit from any treatment that the psychotherapist does not provide, he has an ethical obligation to assist you in obtaining those treatmentsbeen made.

Telephone and Emergency Procedures. If you need to contact the psychotherapist me between sessions, please leave a message on the answering machine (000) voice mail at: 732- 000-0000 and your call will be returned as soon as possible. The psychotherapist checks her I check my messages a few several times a day (but never except during the nighttime), unless she is I am out of town. The psychotherapist checks I check the messages less frequently on weekends and holidays. If an emergency situation arises, please indicate it clearly in your message. If you need to talk to someone right away, you can call the Xxxx Xxxxxx Riverview Medical Center at 0000 Xxxxx Xxx.hotline, Ft. Xxxxx, FL 33905, the which is a 24-hour crisis line (000) 000-0000, the Police (911), or the 24-hour psychiatric emergency numbernumber at Jersey Shore Hospital, (000) 000-00000000 or go to the nearest emergency room. Payments and insurance reimbursement Clients are expected to pay the standard fee of $120 current session rate noted on my website for the initial 75- minute consultation and per 50 - 50-minute session (or $150 for psychologists fee) thereafter. All payments are due at the end of each session unless other or at the end of the month where special arrangements have been made. Telephone conversations, site visits, report writing and reading, consultation with other professionals, release of information, reading records, longer sessions, travel time, and so forth, will be charged at the same rate, unless indicated and agreed otherwise. Please notify the psychotherapist me if any problem arises during the course of therapy regarding your ability to make timely payments. Clients who carry insurance other than insurance networks noted as ‘in-network’, should remember that professional services are rendered and charged to the clients and not to the insurance companies. Unless agreed upon differently, I will provide you with a copy of your receipt on a monthly basis, which you can then submit to your insurance company for reimbursement if you so choose. As was indicated in the section “Health Insurance and Confidentiality of Records,” you must be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk. Not all issues/conditions/problems that are the focus of psychotherapy are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. A regular credit card will Mediation and arbitration All disputes arising out of or in relation to this agreement to provide psychotherapy services shall first be taken over referred to mediation before, and as a precondition of, the phone before initiation of arbitration. The mediator shall be a neutral third party chosen by agreement of Xxxxxxxxx Xxxx; LCSW, LLC and you, the first therapy sessionclient(s). 50% The cost of such mediation, if any, shall be split equally, unless otherwise agreed. In the event that mediation is unsuccessful, any unresolved controversy related to this agreement should be submitted to and settled by binding arbitration in Monmouth County, New Jersey in accordance with the rules of the no show fee will be charged to American Arbitration Association, that are in effect at the credit card to hold time the first appointment or use towards a future missed session. If no session demand for arbitration is missed, you will receive a full reimbursement for the amount heldfiled. The process of therapy/ therapy/evaluation Participation in therapy can result in a number of benefits to youyou and your child, including improving interpersonal relationships and resolution of the specific concerns that led you to seek therapy. Working toward these benefits, however, requires effort on your part. Psychotherapy requires your very active involvement, honesty, and openness in order to change your thoughts, feelings, and/or behavior. The psychotherapist I will ask for your feedback and views on your/your child’s therapy, its progress, and other aspects of the therapy and will expect you to respond openly and honestly. Sometimes more than one approach can be helpful in dealing with a certain situation. During evaluation or therapy, remembering or talking about unpleasant events, feelings, or thoughts can result in your experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, and so forth, or experiencing anxiety, depression, insomnia, and so forth. The psychotherapist may challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations that can cause you to feel very upset, angry, depressed, challenged, or disappointed. Attempting to resolve issues that brought you to therapy in the first place, such as personal or interpersonal relationships, may result in changes that were not originally intended. Psychotherapy may result in decisions about changing behaviors, employment, substance use, schooling, housing, or relationships. Sometimes a decision that is positive for one family member is viewed quite negatively by another family member. Change will sometimes be easy and swift, but more often it will be slow and even frustrating. There is no guarantee that psychotherapy will yield positive or intended results. During the course of therapy, the psychotherapist is I am likely to draw on various psychological approaches according, in part, to the problem that is being treated and his/her my assessment of what will best benefit you. These approaches include behavioral, cognitive-behavioral, psychodynamicchild centered play therapy, existentialEMDR, system/family, developmental (adult, child, family), or psychoeducationaland/or psycho-educational. Discussion of treatment plan Within a reasonable period of time after the initiation of treatment, the psychotherapist I will discuss with you (client) her my working understanding of the problem, treatment plan, therapeutic objectives, problem and view of the possible outcomes of treatment. If you have any unanswered questions about any of the procedures used in the course of your therapy, their possible risks, the psychotherapist’s my expertise in employing them, or about the treatment plan, please ask and you will be answered fully. You also have the right to ask about other treatments for your condition and their risks and benefits. If you could benefit from any treatment that the psychotherapist does I do not provide, he has I have an ethical obligation to assist you in obtaining those treatments.

Telephone and Emergency Procedures. If you need to contact the psychotherapist Xxxx Xxxx Xxxxxxxx-Brookhuis between sessions, please leave a message on the answering machine (000) 000-0000 at 000.000.0000 and your call will be returned as soon as possible. The psychotherapist Xxxx Xxxx Xxxxxxxx-Brookhuis checks her messages a few times a day (but never during the nighttime)each day, unless she is out of town. The psychotherapist checks the messages less frequently on weekends and holidays. If an emergency situation arises, please indicate it clearly in your message. If you need to talk to someone right away, you can call the Xxxx Xxxxxx Center Xxxx Xxxxxxxx-Xxxxxxxx at 0000 Xxxxx Xxx., Ft. Xxxxx, FL 33905770.313.1741, the 24-hour crisis line (000) 000-0000Psych. Emergency at 770.836.9666, the Police police (911), ) or the 24-hour psychiatric emergency number, (000) 000-0000crisis number at 770.836.9551. Payments and insurance reimbursement PAYMENTS AND INSURANCE REIMBURSEMENT: Clients are expected to pay the standard fee of $120 100 per 50 - 50-minute session (or $150 for psychologists fee) at the end of each session unless other arrangements have been made. Telephone conversations, site visits, report writing and reading, consultation with other professionals, release of information, reading records, longer sessions, travel time, and so forthetc., will be charged at the same rate, unless indicated and agreed otherwise. Please notify the psychotherapist Xxxx Xxxx Myllerup-Brookhuis if any problem arises during the course of therapy regarding your ability to make timely payments. Clients who carry insurance should remember that professional services are rendered and charged to the clients, and not to the insurance companies. Unless agreed upon differently, Xxxx Xxxx Xxxxxxxx-Brookhuis will provide you with a copy of your receipt on a monthly basis, which you can then submit to your insurance company for reimbursement if you so choose. As was indicated in the section, Health Insurance and Confidentiality of Records, you must be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk. Not all issues/conditions/problems that problems, which are the focus of psychotherapy psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. A regular credit card will be taken over the phone before the first therapy session. 50% of the no show fee will be charged to the credit card to hold the first appointment or use towards a future missed session. If no session is missed, you will receive a full reimbursement for the amount held. The process of therapy/ evaluation Participation in therapy can result in a number of benefits to you, including improving interpersonal relationships and resolution of the specific concerns that led you to seek therapy. Working toward these benefits, however, requires effort on your part. Psychotherapy requires your very active involvement, honesty, and openness in order to change your thoughts, feelings, and/or behavior. The psychotherapist will ask for your feedback and views on your therapy, its progress, and other aspects of the therapy and will expect you to respond openly and honestly. Sometimes more than one approach can be helpful in dealing with a certain situation. During evaluation or therapy, remembering or talking about unpleasant events, feelings, or thoughts can result in your experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, and so forth, or experiencing anxiety, depression, insomnia, and so forth. The psychotherapist may challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations that can cause you to feel very upset, angry, depressed, challenged, or disappointed. Attempting to resolve issues that brought you to therapy in the first place, such as personal or interpersonal relationships, may result in changes that were not originally intended. Psychotherapy may result in decisions about changing behaviors, employment, substance use, schooling, housing, or relationships. Sometimes a decision that is positive for one family member is viewed quite negatively by another family member. Change will sometimes be easy and swift, but more often it will be slow and even frustrating. There is no guarantee that psychotherapy will yield positive or intended results. During the course of therapy, the psychotherapist is likely to draw on various psychological approaches according, in part, to the problem that is being treated and his/her assessment of what will best benefit you. These approaches include behavioral, cognitive-behavioral, psychodynamic, existential, system/family, developmental (adult, child, family), or psychoeducational. Discussion of treatment plan Within a reasonable period of time after the initiation of treatment, the psychotherapist will discuss with you (client) her working understanding of the problem, treatment plan, therapeutic objectives, and view of the possible outcomes of treatment. If you have any unanswered questions about any of the procedures used in the course of your therapy, their possible risks, the psychotherapist’s expertise in employing them, or about the treatment plan, please ask and you will be answered fully. You also have the right to ask about other treatments for your condition and their risks and benefits. If you could benefit from any treatment that the psychotherapist does not provide, he has an ethical obligation to assist you in obtaining those treatments.

Telephone and Emergency Procedures. If you need to contact the psychotherapist me between sessions, please leave a message on the answering machine (voice mail at: 000) -000-0000 and your call will be returned as soon as possible. The psychotherapist checks her I check my messages a few several times a day (but never except during the nighttime), unless she is I am out of town. The psychotherapist checks I check the messages less frequently on weekends and holidays. If an emergency situation arises, please indicate it clearly in your message. If you need to talk to someone right away, you can call the Xxxx Xxxxxx Riverview Medical Center at 0000 Xxxxx Xxx.hotline, Ft. Xxxxx, FL 33905, the which is a 24-hour crisis line (000) 000-0000, the Police (911), or the 24-hour psychiatric emergency numbernumber at Jersey Shore Hospital, (000) 000-00000000 or go to the nearest emergency room. Payments and insurance reimbursement Clients are expected to pay the standard fee of $120 per 50 - 200 for the initial 75-minute session (or intake assessment. $150 for psychologists fee) per 45-minute individual session and $175 per 60-minute family session thereafter. All payments are due at the end of each session unless other arrangements have been made. Telephone conversations, site visits, report writing and reading, consultation with other professionals, release of information, reading records, longer sessions, travel time, and so forth, will be charged at the same rate, unless indicated and agreed otherwisesession. Please notify the psychotherapist me if any problem arises during the course of therapy regarding your ability to make timely payments. Clients who carry insurance other than insurance networks noted as ‘in-network’, should remember that professional services are rendered and charged to the clients and not to the insurance companies. Unless agreed upon differently, I will provide you with a copy of your receipt on a weekly basis, which you can then submit to your insurance company for reimbursement if you so choose. As was indicated in the section “Health Insurance and Confidentiality of Records,” you must be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk. Not all issues/conditions/problems that are the focus of psychotherapy are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. A regular credit card will Mediation and arbitration All disputes arising out of or in relation to this agreement to provide psychotherapy services shall first be taken over the phone before the first therapy session. 50% of the no show fee will be charged referred to the credit card to hold the first appointment or use towards a future missed session. If no session is missed, you will receive a full reimbursement for the amount held. The process of therapy/ evaluation Participation in therapy can result in a number of benefits to you, including improving interpersonal relationships and resolution of the specific concerns that led you to seek therapy. Working toward these benefits, however, requires effort on your part. Psychotherapy requires your very active involvement, honestymediation before, and openness in order to change your thoughtsas a precondition of, feelings, and/or behavior. The psychotherapist will ask for your feedback and views on your therapy, its progress, and other aspects of the therapy and will expect you to respond openly and honestly. Sometimes more than one approach can be helpful in dealing with a certain situation. During evaluation or therapy, remembering or talking about unpleasant events, feelings, or thoughts can result in your experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, and so forth, or experiencing anxiety, depression, insomnia, and so forth. The psychotherapist may challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations that can cause you to feel very upset, angry, depressed, challenged, or disappointed. Attempting to resolve issues that brought you to therapy in the first place, such as personal or interpersonal relationships, may result in changes that were not originally intended. Psychotherapy may result in decisions about changing behaviors, employment, substance use, schooling, housing, or relationships. Sometimes a decision that is positive for one family member is viewed quite negatively by another family member. Change will sometimes be easy and swift, but more often it will be slow and even frustrating. There is no guarantee that psychotherapy will yield positive or intended results. During the course of therapy, the psychotherapist is likely to draw on various psychological approaches according, in part, to the problem that is being treated and his/her assessment of what will best benefit you. These approaches include behavioral, cognitive-behavioral, psychodynamic, existential, system/family, developmental (adult, child, family), or psychoeducational. Discussion of treatment plan Within a reasonable period of time after the initiation of treatmentarbitration. The mediator shall be a neutral third party chosen by agreement of Profound Insights LLC and you, the psychotherapist will discuss client(s). The cost of such mediation, if any, shall be split equally, unless otherwise agreed. In the event that mediation is unsuccessful, any unresolved controversy related to this agreement should be submitted to and settled by binding arbitration in Monmouth County, New Jersey in accordance with you (client) her working understanding the rules of the problemAmerican Arbitration Association, treatment plan, therapeutic objectives, and view of that are in effect at the possible outcomes of treatment. If you have any unanswered questions about any of time the procedures used in the course of your therapy, their possible risks, the psychotherapist’s expertise in employing them, or about the treatment plan, please ask and you will be answered fully. You also have the right to ask about other treatments demand for your condition and their risks and benefits. If you could benefit from any treatment that the psychotherapist does not provide, he has an ethical obligation to assist you in obtaining those treatmentsarbitration is filed.

Telephone and Emergency Procedures. If you need to contact the psychotherapist between sessions, please leave a message on the answering machine (000) 000-0000 and your call will be returned as soon as possible. The psychotherapist checks her messages a few times a day (but never during the nighttime), unless she is out of town. The psychotherapist checks the messages less frequently on weekends and holidays. If an emergency situation arises, please indicate it clearly in your message. If you need to talk to someone right away, you can call the Xxxx Xxxxxx Center SalusCare at 0000 Xxxxx Xxx., Ft. Xxxxx, FL 33905, the 24-hour crisis line (000) 000-0000, the Police (911), or the 24-hour psychiatric emergency number, (000) 000-0000. Payments and insurance reimbursement Clients are expected to pay the standard fee of $120 135 per 50 - minute session (or $150 200 for psychologists fee) at the end of each session unless other arrangements have been made. Telephone conversations, site visits, report writing and reading, consultation with other professionals, release of information, reading records, longer sessions, travel time, and so forth, will be charged at the same rate, unless indicated and agreed otherwise. Please notify the psychotherapist if any problem arises during the course of therapy regarding your ability to make timely payments. Not all issues/conditions/problems that are the focus of psychotherapy are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. A regular credit card will be taken over the phone before the first therapy session. 50% of the no show fee will be charged to the credit card to hold the first appointment or use towards a future missed session. If no session is missed, you will receive a full reimbursement for the amount held. The process of therapy/ therapy/evaluation Participation in therapy can result in a number of benefits to you, including improving interpersonal relationships and resolution of the specific concerns that led you to seek therapy. Working toward these benefits, however, requires effort on your part. Psychotherapy requires your very active involvement, honesty, and openness in order to change your thoughts, feelings, and/or behavior. The psychotherapist will ask for your feedback and views on your therapy, its progress, and other aspects of the therapy and will expect you to respond openly and honestly. Sometimes more than one approach can be helpful in dealing with a certain situation. During evaluation or therapy, remembering or talking about unpleasant events, feelings, or thoughts can result in your experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, and so forth, or experiencing anxiety, depression, insomnia, and so forth. The psychotherapist may challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations that can cause you to feel very upset, angry, depressed, challenged, or disappointed. Attempting to resolve issues that brought you to therapy in the first place, such as personal or interpersonal relationships, may result in changes that were not originally intended. Psychotherapy may result in decisions about changing behaviors, employment, substance use, schooling, housing, or relationships. Sometimes a decision that is positive for one family member is viewed quite negatively by another family member. Change will sometimes be easy and swift, but more often it will be slow and even frustrating. There is no guarantee that psychotherapy will yield positive or intended results. During the course of therapy, the psychotherapist is likely to draw on various psychological approaches according, in part, to the problem that is being treated and his/her assessment of what will best benefit you. These approaches include behavioral, cognitive-behavioral, psychodynamic, existential, system/family, developmental (adult, child, family), or psychoeducational. Medical Records Request If medical records are requested, it is the policy of I-BOS Counseling Center to only provide a treatment summary. Since therapy notes are subjective, they can be misinterpreted by others. If seeking dates and amounts paid at time of service, the therapist can provide an invoice with the information requested. Discussion of treatment plan Within a reasonable period of time after the initiation of treatment, the psychotherapist will discuss with you (client) her working understanding of the problem, treatment plan, therapeutic objectives, and view of the possible outcomes of treatment. If you have any unanswered questions about any of the procedures used in the course of your therapy, their possible risks, the psychotherapist’s expertise in employing them, or about the treatment plan, please ask and you will be answered fully. You also have the right to ask about other treatments for your condition and their risks and benefits. If you could benefit from any treatment that the psychotherapist does not provide, he has an ethical obligation to assist you in obtaining those treatments. Pets at the office Only certified service animals are allowed at the office. Unfortunately, emotional support animals are no longer permitted. However, we do encourage clients to bring pictures and mementos to share during the therapeutic session.

Telephone and Emergency Procedures. If you need to contact the psychotherapist Xx. Xxxxx or your assigned therapist between sessions, please leave a message on the answering machine her voicemail at (000) 000-0000 0000, and your call will be returned as soon as possible. The psychotherapist Xx. Xxxxx checks her messages a few times a day (but never during the nighttime)regular office hours. Please note, unless she is out of townthat Xx. The psychotherapist Xxxxx checks the messages less frequently on weekends and holidays. If an emergency situation arises, please indicate it clearly in your message. If However, if you need to talk to someone right away, you can call the Xxxx Xxxxxx Center at 0000 Xxxxx Xxx., Ft. Xxxxx, FL 33905, the 24-hour crisis line (000) 000-0000, or the Police (Department 911), or the 24-hour psychiatric emergency number, (000) 000-0000. Payments and insurance reimbursement Clients Patients are expected to pay the standard session fee of $120 per 50 - 55-minute session (or $150 for psychologists fee) at the end beginning of each session unless other arrangements have been madesession. Any services rendered by a Registered Psychological Assistant must be paid directly to Xx. Xxxxx. Telephone conversations, site visits, report writing and reading, consultation with other professionals, release of information, reading records, longer sessions, travel time, and so forth, will be charged at the same rate, unless indicated and agreed otherwise. Please notify the psychotherapist Xx. Xxxxx if any problem arises during the course of therapy regarding your ability to make timely payments. Checks that are returned due to “insufficient funds” will incur a $25 fee. Patients who carry insurance should remember that professional services are rendered and charged to the clients and not to the insurance companies. If requested, Xx. Xxxxx will provide you with a copy of your receipt on a monthly basis, which you can then submit to your insurance company for reimbursement if you so choose. As was indicated in the section “Health Insurance and Confidentiality of Records,” you must be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk. Not all issues/conditions/problems that are the focus of psychotherapy are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. A regular Importantly, there is also a certain level of risk when paying Xx. Xxxxx for psychological services with a credit card will card, via the square, check, or PayPal. Mediation and arbitration All disputes arising out of or in relation to this agreement to provide psychotherapy services shall first be taken over the phone before the first therapy session. 50% of the no show fee will be charged referred to the credit card to hold the first appointment or use towards a future missed session. If no session is missed, you will receive a full reimbursement for the amount held. The process of therapy/ evaluation Participation in therapy can result in a number of benefits to you, including improving interpersonal relationships and resolution of the specific concerns that led you to seek therapy. Working toward these benefits, however, requires effort on your part. Psychotherapy requires your very active involvement, honestymediation before, and openness in order to change your thoughtsas a precondition of, feelings, and/or behavior. The psychotherapist will ask for your feedback and views on your therapy, its progress, and other aspects of the therapy and will expect you to respond openly and honestly. Sometimes more than one approach can be helpful in dealing with a certain situation. During evaluation or therapy, remembering or talking about unpleasant events, feelings, or thoughts can result in your experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, and so forth, or experiencing anxiety, depression, insomnia, and so forth. The psychotherapist may challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations that can cause you to feel very upset, angry, depressed, challenged, or disappointed. Attempting to resolve issues that brought you to therapy in the first place, such as personal or interpersonal relationships, may result in changes that were not originally intended. Psychotherapy may result in decisions about changing behaviors, employment, substance use, schooling, housing, or relationships. Sometimes a decision that is positive for one family member is viewed quite negatively by another family member. Change will sometimes be easy and swift, but more often it will be slow and even frustrating. There is no guarantee that psychotherapy will yield positive or intended results. During the course of therapy, the psychotherapist is likely to draw on various psychological approaches according, in part, to the problem that is being treated and his/her assessment of what will best benefit you. These approaches include behavioral, cognitive-behavioral, psychodynamic, existential, system/family, developmental (adult, child, family), or psychoeducational. Discussion of treatment plan Within a reasonable period of time after the initiation of treatmentarbitration. The mediator shall be a neutral third party chosen by agreement of Xx. Xxxxx and client(s). The cost of such mediation, if any, shall be split equally, unless otherwise agreed. In the event that mediation is unsuccessful, any unresolved controversy related to this agreement should be submitted to and settled by binding arbitration in Fresno County, California in accordance with the rules of the American Arbitration Association, that are in effect at the time the demand for arbitration is filed. Notwithstanding the foregoing, in the event that your account is overdue (unpaid) and there is no agreement on a payment plan, Xx. Xxxxx can use legal means (court, collection agency, etc.) to obtain payment. The prevailing party in arbitration or collection proceedings shall be entitled to recover a reasonable sum for attorneys’ fees. In the case of arbitration, the psychotherapist arbitrator will discuss with you (client) her working understanding of the problem, treatment plan, therapeutic objectives, and view of the possible outcomes of treatment. If you have any unanswered questions about any of the procedures used in the course of your therapy, their possible risks, the psychotherapist’s expertise in employing them, or about the treatment plan, please ask and you will be answered fully. You also have the right to ask about other treatments for your condition and their risks and benefits. If you could benefit from any treatment determine that the psychotherapist does not provide, he has an ethical obligation to assist you in obtaining those treatmentssum.

Telephone and Emergency Procedures. If you need to contact the psychotherapist Xx. Xxxxxxxxx between sessions, please leave a message on the answering machine voice mail service (000) 000-0000 and your call will be returned as soon as possible. The psychotherapist Please call from 9:00a.m. to 8:00p.m. for non-emergency calls. Call between 8:00p.m. and 9:00a.m. only if it is urgent. Xx. Xxxxxxxxx checks her his messages a few several times a day (but never during the nighttime)week. Please leave your name, unless she is out the date, and your telephone number where Xx. Xxxxxxxxx can reach you, even if you think Xx. Xxxxxxxxx already has it. In case of town. The psychotherapist checks the messages less frequently on weekends and holidays. If an emergency situation arisesemergency, please indicate it clearly in your messagemessage and Xx. Xxxxxxxxx will call you back as soon as he is able to. If you need to talk to someone right away, you can please call the Xxxx Xxxxxx Center at 0000 Xxxxx Xxx., Ft. Xxxxx, FL 33905, the 24-24 hour crisis line (000) 000-0000, the Police (911), or the 24-24 hour psychiatric emergency number, (000) 000-0000Psychiatric Emergency. Payments Payment and insurance reimbursement Insurance Reimbursement: Clients are expected to pay the agreed upon fee, which may be the full fee, a sliding scale fee, or in insurance cases, a co-payment. The standard fee of is $120 195 per 50 - 60-minute session (or $150 for psychologists fee) session, which should be paid at the end of each session session, unless other arrangements have been made. Telephone conversations, site visits, report writing and reading, consultation with other professionals, release of information, reading records, longer sessions, travel time, and so forthetc... , will may be charged at the same rate, unless indicated and agreed otherwise. Please notify the psychotherapist Xx. Xxxxxxxxx if any problem arises during the course of therapy regarding your ability to make timely payments. Please remember Professional services are rendered and charged to the clients and not to the insurance company. Xx. Xxxxxxxxx'x Billing Service will submit your bill to your insurance company at least twice a month. Not all issues/conditions/problems that which are the focus of psychotherapy are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. A regular credit card will be taken over Should insurance not cover visits, full payment is due for completed visits. Payment for visits is ultimately the phone before the first therapy session. 50% responsibility of the no show fee will be charged to the credit card to hold the first appointment or use towards a future missed session. If no session is missed, you will receive a full reimbursement for the amount held. The process of therapy/ evaluation Participation in therapy can result in a number of benefits to you, including improving interpersonal relationships and resolution of the specific concerns that led you to seek therapy. Working toward these benefits, however, requires effort on your part. Psychotherapy requires your very active involvement, honesty, and openness in order to change your thoughts, feelings, and/or behavior. The psychotherapist will ask for your feedback and views on your therapy, its progress, and other aspects of the therapy and will expect you to respond openly and honestly. Sometimes more than one approach can be helpful in dealing with a certain situation. During evaluation or therapy, remembering or talking about unpleasant events, feelings, or thoughts can result in your experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, and so forth, or experiencing anxiety, depression, insomnia, and so forth. The psychotherapist may challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations that can cause you to feel very upset, angry, depressed, challenged, or disappointed. Attempting to resolve issues that brought you to therapy in the first place, such as personal or interpersonal relationships, may result in changes that were not originally intended. Psychotherapy may result in decisions about changing behaviors, employment, substance use, schooling, housing, or relationships. Sometimes a decision that is positive for one family member is viewed quite negatively by another family member. Change will sometimes be easy and swift, but more often it will be slow and even frustrating. There is no guarantee that psychotherapy will yield positive or intended results. During the course of therapy, the psychotherapist is likely to draw on various psychological approaches according, in part, to the problem that is being treated and his/her assessment of what will best benefit you. These approaches include behavioral, cognitive-behavioral, psychodynamic, existential, system/family, developmental (adult, child, family), or psychoeducational. Discussion of treatment plan Within a reasonable period of time after the initiation of treatment, the psychotherapist will discuss with you (client) her working understanding of the problem, treatment plan, therapeutic objectives, and view of the possible outcomes of treatment. If you have any unanswered questions about any of the procedures used in the course of your therapy, their possible risks, the psychotherapist’s expertise in employing them, or about the treatment plan, please ask and you will be answered fully. You also have the right to ask about other treatments for your condition and their risks and benefits. If you could benefit from any treatment that the psychotherapist does not provide, he has an ethical obligation to assist you in obtaining those treatments.

Telephone and Emergency Procedures. If you need to contact the psychotherapist me between sessions, please leave a message on the answering machine (000) voice mail at: 000- 000-0000 and your call will be returned as soon as possible. The psychotherapist checks her I check my messages a few several times a day (but never except during the nighttime), unless she is I am out of town. The psychotherapist checks I check the messages less frequently on weekends and holidays. If an emergency situation arises, please indicate it clearly in your message. If you need to talk to someone right away, you can call the Xxxx Xxxxxx Riverview Medical Center at 0000 Xxxxx Xxx.hotline, Ft. Xxxxx, FL 33905, the which is a 24-hour crisis line (000) 000-0000, the Police (911), or the 24-hour psychiatric emergency numbernumber at Jersey Shore Hospital, (000) 000-00000000 or go to the nearest emergency room. Payments and insurance reimbursement Clients are expected to pay the standard fee of $120 per 50 - 200 for the initial 75-minute session (or intake assessment. $150 for psychologists fee) per 45-minute individual session and $175 per 60-minute family session thereafter. All payments are due at the end of each session unless other arrangements have been made. Telephone conversations, site visits, report writing and reading, consultation with other professionals, release of information, reading records, longer sessions, travel time, and so forth, will be charged at the same rate, unless indicated and agreed otherwisesession. Please notify the psychotherapist me if any problem arises during the course of therapy regarding your ability to make timely payments. Clients who carry insurance other than insurance networks noted as ‘in-network’, should remember that professional services are rendered and charged to the clients and not to the insurance companies. Unless agreed upon differently, I will provide you with a copy of your receipt on a weekly basis, which you can then submit to your insurance company for reimbursement if you so choose. As was indicated in the section “Health Insurance and Confidentiality of Records,” you must be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk. Not all issues/conditions/problems that are the focus of psychotherapy are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. A regular credit card will Mediation and arbitration All disputes arising out of or in relation to this agreement to provide psychotherapy services shall first be taken over referred to mediation before, and as a precondition of, the phone before initiation of arbitration. The mediator shall be a neutral third party chosen by agreement of Profound Insights LLC and you, the first therapy sessionclient(s). 50% The cost of such mediation, if any, shall be split equally, unless otherwise agreed. In the event that mediation is unsuccessful, any unresolved controversy related to this agreement should be submitted to and settled by binding arbitration in Monmouth County, New Jersey in accordance with the rules of the no show fee will be charged to American Arbitration Association, that are in effect at the credit card to hold time the first appointment or use towards a future missed session. If no session demand for arbitration is missed, you will receive a full reimbursement for the amount heldfiled. The process of therapy/ therapy/evaluation Participation in therapy can result in a number of benefits to youyou and your child, including improving interpersonal relationships and resolution of the specific concerns that led you to seek therapy. Working toward these benefits, however, requires effort on your part. Psychotherapy requires your very active involvement, honesty, and openness in order to change your thoughts, feelings, and/or behavior. The psychotherapist I will ask for your feedback and views on your/your child’s therapy, its progress, and other aspects of the therapy and will expect you to respond openly and honestly. Sometimes more than one approach can be helpful in dealing with a certain situation. During evaluation or therapy, remembering or talking about unpleasant events, feelings, or thoughts can result in your experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, and so forth, or experiencing anxiety, depression, insomnia, and so forth. The psychotherapist may challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations that can cause you to feel very upset, angry, depressed, challenged, or disappointed. Attempting to resolve issues that brought you to therapy in the first place, such as personal or interpersonal relationships, may result in changes that were not originally intended. Psychotherapy may result in decisions about changing behaviors, employment, substance use, schooling, housing, or relationships. Sometimes a decision that is positive for one family member is viewed quite negatively by another family member. Change will sometimes be easy and swift, but more often it will be slow and even frustrating. There is no guarantee that psychotherapy will yield positive or intended results. During the course of therapy, the psychotherapist is I am likely to draw on various psychological approaches according, in part, to the problem that is being treated and his/her my assessment of what will best benefit you. These approaches include behavioral, cognitive-behavioral, psychodynamic, existentialplay therapy, system/family, developmental (adult, child, adolescent, young adult & family), or psychoeducationaland/or psycho-educational. Discussion of treatment plan Within a reasonable period of time after the initiation of treatment, the psychotherapist I will discuss with you (client) her my working understanding of the problem, treatment plan, therapeutic objectives, problem and view of the possible outcomes of treatment. If you have any unanswered questions about any of the procedures used in the course of your therapy, their possible risks, the psychotherapist’s my expertise in employing them, or about the treatment plan, please ask and you will be answered fully. You also have the right to ask about other treatments for your condition and their risks and benefits. If you could benefit from any treatment that the psychotherapist does I do not provide, he has I have an ethical obligation to assist you in obtaining those treatments.