OFFICE POLICIES & GENERAL INFORMATION AGREEMENT FOR PSYCHOTHERAPY SERVICESOffice Policies & General Information Agreement for Psychotherapy Services • April 16th, 2021
Contract Type FiledApril 16th, 2021CONFIDENTIALITY: All information disclosed within sessions and the written records pertaining to those sessions are confidential and may not be revealed to anyone without your (client’s) written permission, except where disclosure is required by law or in cases of peer consultation. Most of the provisions explaining when the law requires disclosure were described to you in the Notice of Privacy Practices that you received with this form. Ms. Bernstein has an ethical “duty to warn” in the event that a member or members of society become threatened by the actions of the client. If child abuse, elder abuse, or any similar behavior is suspected, reporting is required by law. By signing this agreement, you hereby give permission to Barbara Bernstein to disclose any information that she believes to be necessary to any persons or agencies for the protection of those involved in this case or others. This permission extends to the protection of any other persons not competent to manage his/her