TERMINATION OF TREATMENT. Length of treatment: The length of time required for therapy will be determined by your personal situation. I will do my best to fulfill your therapeutic needs and provide you with the best therapeutic care. For your part, you agree to participate in the process to the best of your ability. It is intended that when your needs are met, to the extent they can be, we will terminate our relationship. Client Termination: You may terminate services at any time. This may be done in several ways. These include, but are not limited to, putting it in writing or informing me verbally. If you choose to terminate therapy with me, it will be my decision as to whether we can re-establish our therapeutic relationship if you request to do so in the future. In such circumstances, referrals to other therapists or agencies will be provided if requested. Therapist Termination: A pattern of frequently canceled or missed appointments will result in termination. Non-payment for services may result in termination. If I feel that the services I can offer are not or will not be appropriate for you, I may, after discussing reasons with you, refer you to another provider or agency. Furthermore, I reserve the right to terminate service if dangerous/risky behaviors are continued or if sessions are attended after consuming drugs or alcohol. Regardless of the reason for ending treatment, I ask that you allow yourself/your child to have 1-3 closure sessions. HIPAA The information about HIPAA included in this agreement, along with the Texas Notice Form describes your rights with regards to your Clinical Record and disclosures of protected health information. Your signature below serves as an acknowledgement that you have received the HIPAA notice. X Client/Guardian Printed Name X X Client/Guardian Signature Date If you are dissatisfied with any aspect of the counseling process, please inform my office so I can determine if our work together can be more efficient and effective or whether a referral would be appropriate. If you believe you have been treated unfairly or unethically, and I cannot resolve the problem, contact: Texas State Board of Examiners of Professional Counselor Complaint Process Complaints Management and Investigative Section P.O. Box 141369 Austin, Texas 00000-0000 Or call 0-000-000-0000 Session and Fees: Schedule of Fees Type of Service Fee Initial Consultation $275.00 45 Minute (Individual) Session $180.00 25 minute (Individual) Session $90.00 90 Minute Session $275.00 A...
TERMINATION OF TREATMENT. The length of time required for therapy will be determined by your personal situation. Your clinician will do their best to fulfill your therapeutic needs and provide you with the best therapeutic care. For your part, you agree to participate in the process to the best of your ability. It is intended that when your needs are met, to the extent they can be, the therapeutic relationship will terminate. Although many people report benefits from therapy, there is no guarantee of a cure.
TERMINATION OF TREATMENT. If I feel that the services I can offer are not, or will not be appropriate for you, I may, after discussing reasons with you, refer you to another provider or agency. Furthermore, I reserve the right to terminate service if treatment recommendations are not followed. Such situations include: if payment is not timely, if recommended consultations are not sought, if medication is not taken as prescribed mental health continuity, if dangerous practices are continued, or if sessions are attended after consuming drugs or alcohol.
TERMINATION OF TREATMENT. Initial/ Physical Assault, verbally threatening behavior towards staff, other patients, or physical property, and/or significant disruption of the office environment will be cause for immediate termination of treatment and you will be held responsible for damages. Firearms and other weapons are prohibited, with exception for an officer of the law. Non-compliance with treatment (missed appointments, failure to follow treatment plans, misuse of medications, and violation of any office policies) is grounds for termination of treatment.
TERMINATION OF TREATMENT. You have the right to decide to end treatment at any time and for any reasons. If you are thinking about ending therapy, we encourage you to discuss this with your therapist so that they may minimize terminating treatment against medical advice. If termination of treatment is indicated, we can provide you with names of other mental health providers. Your therapist has the right to terminate therapy due to, but not limited to, the following reasons: untimely payment of fees, failure to comply with treatment recommendations, conflict of interest, failure to participate in therapy, a client’s needs are outside the therapist’s scope of competence or practice, or a client is not making adequate progress in therapy. If you cancel and/or miss six (6) consecutive scheduled appointments in a row, this is considered as inactive and you will be discharged and terminated from treatment.
TERMINATION OF TREATMENT. You are under no obligation to continue services and may opt to terminate treatment. Should you decide to discontinue treatment, we strongly urge you to notify the doctor of your decision so that it may be discussed openly.
TERMINATION OF TREATMENT. You have the right to terminate therapy/psychiatric service at any time and for any reason. It is our hope that termination of therapy will naturally come after you feel that you have made progress on all of your therapy goals and are feeling a general sense of well-being. You are encouraged to make an appointment in the future if you ever need a “check-up” or would like to restart therapy for different issues. For psychiatric treatment, it is important that you follow the advice of your prescriber and if you terminate services with him or her, do not stop your medication without their consent.
TERMINATION OF TREATMENT. The therapist may terminate treatment if the treatment plan is not being followed by the client, if the client is not refraining from dangerous practices, if the client is not following through with recommendations such as a psychiatric evaluation, if some problem emerges that is not within the scope of competence of the therapist, or if payment is not timely. The usual minimal termination for an ongoing treatment process is 2 to 3 sessions. Clients have the right to refuse or to discontinue services at any time. My hourly fee is $150 or as set by insurance/managed care contract. I charge this amount for other professional services (except legal) you may need, though I will break down the hourly cost if I work for periods of less than one hour. If you become involved in legal proceedings that require my participation, you will be expected to pay for my professional time even if I am called to testify by another party. Because of the difficulty of legal involvement, I charge $200 per hour for preparation and attendance at any legal proceeding, payable in advance. Client is responsible for all legal costs arising out of my contact with him/her.
TERMINATION OF TREATMENT. Termination of the educational therapy plan before the agreed date will be scheduled a minimum of two weeks in advance to ensure proper closure to the educational therapy sessions.
TERMINATION OF TREATMENT. Termination of treatment is usually mutually agreed upon by both of us when treatment has successfully concluded. Either of us may terminate treatment if we feel it is not proceeding in a manner that will be successful or it the contract for treatment is not being followed. If, for any reason, you do not feel that your treatment is going as you had hoped, please bring this up in your sessions so we can discuss your concerns and ideally change or adapt the treatment or make modifications. If you would like to get a second opinion, please let me know so I can assist you in finding another therapist. If you decide to terminate therapy, I would also appreciate knowing this. If I do not hear from you to schedule an appointment agreed upon, I will assume you do not wish to continue treatment after 15 days.
