Common use of Client Privilege Clause in Contracts

Client Privilege. The information disclosed by the Client, as well as any records created, is subject to the psychotherapist-client privilege. The psychotherapist-client privilege results from the special relationship between the Therapist and the Client in the eyes of the law. It is akin to the attorney-client privilege or the doctor-patient privilege. Typically, the Client is the holder of the psychotherapist-client privilege. If the Therapist received a subpoena for records, deposition testimony, or testimony in a court of law, the Therapist will assert the psychotherapist-client privilege on the Client’s behalf until instructed in writing to do otherwise by the Client or the Client’s representative. The Client should be aware that he/she might be waiving the psychotherapist- client privilege if he/she makes his/her mental or emotional state an issue in a legal proceeding. The Client should address any concerns he/she might have regarding the psychotherapist-client privilege with his/her attorney. Fee and Fee Arrangements: The fee you are quoted is comparable to most of the Therapists in this area. The Client is expected to pay for services at the time services are rendered. It is asked that you pay your fee at the end of each session. Checks should be made payable to Xxxxxxxx Xxxxx. Please note: The Client is responsible for additional charges as the result of insufficient funds or other payment denial by the client’s bank or credit card institution (Typically $30.00). The fee for services is $195.00 per 50-minute session. Sessions longer than 50 minutes are charged for the additional time pro rata (80 minutes @ $290.00). Assessments and Emergency Sessions may be subject to additional fees, which your therapist will advise you of prior to meeting with you. The Therapist reserves the right to periodically adjust fees. The Client will be notified of any fee adjustment at least 30 days in advance. Your fee will be re-evaluated regularly and also at those times when your financial circumstances change. From time-to-time, the Therapist may engage in telephone contact with the Client for purposes other than scheduling sessions. The Client is responsible for payment of the agreed upon fee (on a pro rata basis) for any telephone calls longer than 10 minutes. In addition, from time-to- time, the Therapist may engage in telephone contact with third parties at the Client’s request and with the Client’s advance written authorization. The Client is responsible for payment of the agreed upon fee (on a pro rata basis) for any telephone calls longer than 10 minutes. If the Client chooses to pay by Mastercard or Visa the payee on their statement will be Comprehensive Human Services Inc. This is the name of The Therapist’s Corporation.

Client Privilege. The information disclosed by the Client, as well as any records created, is subject to the psychotherapist-client privilege. The psychotherapist-client privilege results from the special relationship between the Therapist and the Client in the eyes of the law. It is akin to the attorney-client privilege or the doctor-patient client privilege. Typically, the Client is the holder of the psychotherapist-client privilege. If the Therapist received a subpoena for records, deposition testimony, or testimony in a court of law, the Therapist will assert the psychotherapist-client privilege on the Client’s behalf until instructed instructed, in writing writing, to do otherwise by the Client or the Client’s representative. The Client should be aware that he/she might be waiving the psychotherapist- psychotherapist-client privilege if he/she makes his/her mental or emotional state an issue in a legal proceeding. The Client should address any concerns he/she might have regarding the psychotherapist-client privilege with his/her attorney. Fee and Fee Arrangements: Arrangements The fee you are quoted is comparable to most of the Therapists in this area. The Client is expected to pay for services at the time services are rendered. It is asked that you pay your fee at the end of each session. Checks should be made payable to Xxxxxxxx Xxxxx. Please note: The Client is responsible for additional charges as the result of insufficient funds or other payment denial by the client’s bank or credit card institution (Typically $30.00). The usual and customary fee for services service is $195.00 per 50-for a 50 minute session. Sessions longer than 50 minutes are charged for the additional time pro rata (80 minutes @ $290.00). Assessments and Emergency Sessions may be subject to additional fees, which your therapist will advise you of prior to meeting with yourata. The Therapist reserves the right to periodically adjust feesthis fee. The Client will be notified of any fee adjustment at least 30 days in advance. Your In addition, this fee may be adjusted by contract with insurance companies, managed care organizations, or other third-party payers, or by agreement with the Therapist. The agreed upon fee between the Therapist and the Client is . The Therapist reserves the right to periodically adjust fee. The Client will be re-evaluated regularly and also at those times when your financial circumstances changenotified of any fee adjustment in advance. From time-to-time to time, the Therapist may engage in telephone contact with the Client for purposes other than scheduling sessions. The Client is responsible for payment of the agreed upon fee (on a pro rata basis) for any telephone calls longer than 10 ten minutes. In addition, from time-to- to-time, the Therapist may engage in telephone contact with third parties at the Client’s request and with the Client’s advance written authorization. The Client is responsible for payment of the agreed upon fee (on a pro rata basis) for any telephone calls longer than 10 ten minutes. If the Client chooses Clients are expected to pay by Mastercard or Visa for services at the payee on their statement will be Comprehensive Human Services Inc. This is the name of time services are rendered. The Therapist’s CorporationTherapist accepts cash and checks.

Client Privilege. The information disclosed by the Client, as well as any records created, is subject to the psychotherapist-psychotherapist- client privilege. The psychotherapist-client privilege results from the special relationship between the Therapist and the Client in the eyes of the law. It is akin to the attorney-client privilege or the doctor-patient privilege. Typically, the Client client is the holder of the psychotherapist-client privilege. If the Therapist received a subpoena for records, deposition testimony, or testimony in a court of law, the Therapist will assert the psychotherapist-client privilege on Client's behalf. When a client is a minor child, the holder of the psychotherapist-client privilege is either the minor, a court appointed guardian, or minor’s counsel. Parents typically do not have the authority to waive the psychotherapist-client privilege for their minor children, unless given such authority by a court of law. Representative is encouraged to discuss any concerns regarding the psychotherapist-client privilege with his/her attorney. Client’s behalf until instructed in writing to do otherwise by the Client , or the Client’s representative. The Client Representative, should be aware that he/she might be waiving the psychotherapist- psychotherapist-client privilege if he/she makes his/her mental or emotional state an issue in a legal proceeding. The Client Client, or Representative, should address any concerns he/she might have regarding the psychotherapist-client privilege with his/her attorney. Fee and Fee Arrangements: Arrangements The fee you are quoted is comparable to most of the Therapists in this area. The Client is expected to pay for services at the time services are rendered. It is asked that you pay your fee at the end of each session. Checks should be made payable to Xxxxxxxx Xxxxx. Please note: The Client is responsible for additional charges as the result of insufficient funds or other payment denial by the client’s bank or credit card institution (Typically $30.00). The usual and customary fee for services service is $195.00 120.00 per 50-50- minute session and $150.00 per 90- minute session. Sessions longer than 50 minutes are charged for the additional time pro rata (80 minutes @ $290.00). Assessments and Emergency Sessions may be subject to additional fees, which your therapist will advise you of prior to meeting with you. The Therapist reserves the right to periodically adjust feesthis fee. The Client Representative will be notified of any fee adjustment at least 30 days in advance. Your In addition, this fee will may be readjusted by contract with insurance companies, managed care organizations, or other third-evaluated regularly and also at those times when your financial circumstances changeparty payors, or by agreement with Therapist. From time-to-time, the Therapist may engage in telephone contact with the Client or Representative for purposes other than scheduling sessions. The Client Representative is responsible for payment of the agreed upon fee (on a pro rata basis) for any telephone calls longer than 10 ten minutes. In addition, from time-to- to-time, the Therapist may engage in telephone contact with third parties at the Client’s request of Client or Representative and with the Client’s advance written authorizationauthorization of Client or Representative. The Client Representative is responsible for payment of the agreed upon fee (on a pro rata basis) for any telephone calls longer than 10 ten minutes. If the Client chooses Representative is expected to pay by Mastercard or Visa for services at the payee on their statement will be Comprehensive Human Services Inc. This is the name of The Therapist’s Corporationtime services are rendered. Therapist accepts cash, checks, and major credit cards.

Client Privilege. The information disclosed by the Client, as well as any records created, is subject to the psychotherapist-client privilege. The psychotherapist-client privilege results from the special relationship between the Therapist and the Client in the eyes of the law. It is akin to the attorney-client privilege or the doctor-patient client privilege. Typically, the Client client is the holder of the psychotherapist-client privilege. If the Therapist received a subpoena for records, deposition testimony, or testimony in a court of law, the Therapist will assert the psychotherapist-client privilege on the Client’s behalf until instructed instructed, in writing writing, to do otherwise by the Client or the Client’s representative. The Client should be aware that he/she might be waiving the psychotherapist- psychotherapist-client privilege if he/she makes his/her mental or emotional state an issue in a legal proceeding. The Client should address any concerns he/she might have regarding the psychotherapist-client privilege with his/her attorney. Fee and Fee Arrangements: Arrangements The fee you are quoted is comparable to most of the Therapists in this area. The Client is expected to pay for services at the time services are rendered. It is asked that you pay your fee at the end of each session. Checks should be made payable to Xxxxxxxx Xxxxx. Please note: The Client is responsible for additional charges as the result of insufficient funds or other payment denial by the client’s bank or credit card institution (Typically $30.00). The usual and customary fee for services service is $195.00 120 per 5045-minute session. Sessions longer than 50 45-minutes are charged for the additional time pro rata (80 minutes @ $290.00)rata. Assessments and Emergency Sessions may be subject to additional fees, which your therapist will advise you of prior to meeting with you. The Therapist reserves the right to periodically adjust feesthis fee. The Client will be notified of any fee adjustment at least 30 days in advance. Your In addition, this fee may be adjusted by contract with insurance companies, managed care organizations, or other third-party payors, or by agreement with Therapist. The agreed upon fee between Therapist and Client is [insert usual and customary fee, or other agreed upon fee] ______________. Therapist reserves the right to periodically adjust fee. Client will be re-evaluated regularly and also at those times when your financial circumstances changenotified of any fee adjustment in advance. From time-to-time, the Therapist may engage in telephone contact with the Client for purposes other than scheduling sessions. The Client is responsible for payment of the agreed upon fee (on a pro rata basis) for any telephone calls longer than 10 ten minutes. In addition, from time-to- to-time, the Therapist may engage in telephone contact with third parties at the Client’s request and with the Client’s advance written authorization. The Client is responsible for payment of the agreed upon fee (on a pro rata basis) for any telephone calls longer than 10 ten minutes. If the Client chooses Clients are expected to pay for services at the time services are rendered. Therapist accepts cash, checks, debit cards and major credit cards. Insurance Client is responsible for any and all fees not reimbursed by Mastercard his/her insurance company, managed care organization, or Visa any other third-party payor. Client is responsible for verifying and understanding the payee on their statement limits of his/her coverage, as well as his/her co-payments and deductibles. Therapist is a contracted provider with the following companies: Anthem/Blue Cross, Magellan/Blue Shield, Value Options/Beacon, Military One Source, Humana, The Xxxxxx Group and some EAPs and has agreed by contract to a specified fee. Other insurance companies may have “out of network” clauses that will be Comprehensive Human Services Inc. This is the name allow for reimbursement. If Client intends to use benefits of The Therapist’s Corporationhis/her health insurance policy, Client agrees to inform Therapist in advance.

Client Privilege. The information disclosed by the Client, as well as any records created, is subject to the psychotherapist-client psychotherapist Client privilege. The psychotherapist-client Client privilege results from the special relationship between the Therapist and the Client in the eyes of the law. It is akin to the attorney-client privilege or the doctor-patient Client privilege. Typically, the Client is the holder of the psychotherapist-client Client privilege. If the Therapist received a subpoena for records, deposition testimony, or testimony in a court of law, the Therapist will assert the psychotherapist-client Client privilege on the Client’s behalf until instructed instructed, in writing writing, to do otherwise by the Client or the Client’s representative. The Client should be aware that he/she might be waiving the psychotherapist- client Client privilege if he/she makes his/her mental or emotional state an issue in a legal proceeding. The Client should address any concerns he/she might have regarding the psychotherapist-client Client privilege with his/her attorney. Fee and Fee Arrangements: Arrangements The fee you are quoted is comparable to most of the Therapists in this area. The Client is expected to pay for services at the time services are rendered. It is asked that you pay your fee at the end of each session. Checks should be made payable to Xxxxxxxx Xxxxx. Please note: The Client is responsible for additional charges as the result of insufficient funds or other payment denial by the client’s bank or credit card institution (Typically $30.00). The usual and customary fee for services service is $195.00 175 per 5045-minute session. Sessions longer than 50 45-minutes are charged for the additional time pro rata (80 minutes @ $290.00)rata. Assessments and Emergency Sessions may be subject to additional fees, which your therapist will advise you of prior to meeting with you. The Therapist reserves the right to periodically adjust feesthis fee. The Client will be notified of any fee adjustment at least 30 days in advance. Your In addition, this fee may be adjusted by contract with other third- party payors, or by agreement with Therapist. The agreed upon fee between Therapist and Client is . Therapist reserves the right to periodically adjust his fee. Client will be re-evaluated regularly notified of any fee adjustment in advance. A Client’s appointment is reserved exclusively for the Client. Client will be charged the full fee per session for any missed or cancelled appointments. Client Initials: Unless you have made special arrangements with Therapist, if Client misses two or more appointments in a row Therapist may not be able to hold the appointment time and also at those times when your financial circumstances changeClient may lose their time slot. From time-to-time, the Therapist may engage in telephone contact with the Client for purposes other than scheduling sessions. The Client is responsible for payment of the agreed upon fee (on a pro rata basis) for any telephone calls longer than 10 ten minutes. In addition, from time-to- to-time, the Therapist may engage in telephone contact with third parties at the Client’s request and with the Client’s advance written authorization. The Client is responsible for payment of the agreed upon fee (on a pro rata basis) for any telephone calls longer than 10 ten minutes. If the Client chooses All past due accounts which have not had payment activity for 30 days or more will be reviewed and may be referred to a collection agency. Collection fees may be added to these accounts. The Client, or responsible party, agrees to pay by Mastercard or Visa Xxxxxx Xxxxxxxx, MA, LMFT, any reasonable costs of collection, plus attorney fees and court costs in the payee on event that legal action is required for collection of fees. Like many other mental health providers, Therapist has formal relationships only with some managed health care providers. These are Aetna and MHN. Therapist does accept referrals only from these managed health care providers and will otherwise only be accepting private pay clients. The reasons for this include the overwhelming administrative time spent in dealing with insurance companies and financial concerns. This means private pay clients are expected to pay full fee at the time services are rendered while managed health care clients are expected to pay their statement co-pay. A private pay client may wish to submit statements to their insurance companies, since some will provide limited reimbursement for “off-plan providers.” If Client submits a bill for reimbursement, Client needs to make it clear that the Client/Member is to be Comprehensive Human Services Inc. This is reimbursed, not the name of The Therapist’s Corporationprovider. Clients are expected to pay for services at the time services are rendered. Therapist accepts cash, checks, and select credit cards.

Client Privilege. The information disclosed by the Client, as well as any records created, is subject to the psychotherapist-client privilege. The psychotherapist-client privilege results from the special relationship between the Therapist and the Client in the eyes of the law. It is akin to the attorney-client privilege or the doctor-patient client privilege. Typically, the Client client is the holder of the psychotherapist-psychotherapist- client privilege. If the Therapist received a subpoena for records, deposition testimony, or testimony in a court of law, the Therapist will assert the psychotherapist-client privilege on the Client’s behalf until instructed instructed, in writing writing, to do otherwise by the Client or the Client’s representative. The Client should be aware that he/she might be waiving the psychotherapist- psychotherapist-client privilege if he/she makes his/her mental or emotional state an issue in a legal proceeding. The Client should address any concerns he/she might have regarding the psychotherapist-client privilege with his/her attorney. Fee and Fee Arrangements: Arrangements The fee you are quoted is comparable to most of the Therapists in this area. The Client is expected to pay for services at the time services are rendered. It is asked that you pay your fee at the end of each session. Checks should be made payable to Xxxxxxxx Xxxxx. Please note: The Client is responsible for additional charges as the result of insufficient funds or other payment denial by the client’s bank or credit card institution (Typically $30.00). The usual and customary fee for services service is $195.00 150 per 5045-minute session. Sessions longer than 50 45- minutes are charged for the additional time pro rata (80 minutes @ $290.00)rata. Assessments and Emergency Sessions may be subject to additional fees, which your therapist will advise you of prior to meeting with you. The Therapist reserves the right to periodically adjust feesthis fee. The Client will be notified of any fee adjustment at least 30 days in advance. Your In addition, this fee may be adjusted by contract with insurance companies, managed care organizations, or other third- party payors, or by agreement with Therapist. The agreed upon fee between Therapist and Client will be re-evaluated regularly and also at those times when your financial circumstances change. From time-to-time, the Therapist may engage in telephone contact with the Client for purposes other than scheduling sessions. The Client is responsible for payment of the agreed upon fee (on a pro rata basis) for any telephone calls longer than 10 ten minutes. In addition, from time-to- to-time, the Therapist may engage in telephone contact with third parties at the Client’s request and with the Client’s advance written authorization. The Client is responsible for payment of the agreed upon fee (on a pro rata basis) for any telephone calls longer than 10 minutes. If the Client chooses Clients are expected to pay by Mastercard or Visa for services at the payee on their statement will be Comprehensive Human Services Inc. This is the name of The Therapist’s Corporationtime services are rendered. Therapist accepts cash, checks, debit cards and major credit cards.

Client Privilege. The information disclosed by the Clientclient, as well as any records created, is subject to the psychotherapist-client privilege. The psychotherapist-client patient privilege results from the special relationship between the Therapist and the Client client in the eyes of the law. It is akin to the attorney-client privilege or the doctor-patient privilege. Typically, the Client client is the holder of the psychotherapist-client privilege. If the Therapist received a subpoena for records, deposition testimony, or testimony in a court of law, the Therapist will assert the psychotherapist-client privilege on the Clientclient’s behalf until instructed instructed, in writing writing, to do otherwise by the Client client or the Clientclient’s representative. The Client should be aware that he/she might be waiving the psychotherapist- client privilege if he/she makes his/her mental or emotional state an issue in a legal proceeding. The Client should address any concerns he/she might have regarding the psychotherapist-client privilege with his/her attorney. Fee and Fee Arrangements: Arrangements The fee you are quoted is comparable to most of the Therapists in this area. The Client is expected to pay for services at the time services are rendered. It is asked that you pay your fee at the end of each session. Checks should be made payable to Xxxxxxxx Xxxxx. Please note: The Client is responsible for additional charges as the result of insufficient funds or other payment denial by the client’s bank or credit card institution (Typically $30.00). The usual and customary fee for services service is $195.00 per 50-minute session. Sessions longer than 50 50- minutes are charged for the additional time pro rata (80 minutes @ $290.00)rata. Assessments and Emergency Sessions may be subject to additional fees, which your therapist will advise you of prior to meeting with you. The Therapist reserves the right to periodically adjust feesthis fee. The Client will be notified of any fee adjustment at least 30 days in advance. Your fee will be re-evaluated regularly and also at those times when your financial circumstances change. From time-to-time, the Therapist may engage in telephone contact with the Client for purposes other than scheduling sessions. The Client is responsible for payment of the agreed upon fee (on a pro rata basis) for any telephone calls longer than 10 ten minutes. In addition, from time-to- to-time, the Therapist may engage in telephone contact with third parties at the Client’s request and with the Client’s advance written authorization. The Client is responsible for payment of the agreed upon fee (on a pro rata basis) for any telephone calls longer than 10 ten minutes. If the Client chooses * Clients are expected to pay for services at the time services are rendered. Therapist accepts cash, checks and money orders Insurance Patient is responsible for any and all fees not reimbursed by Mastercard his/her insurance company, managed care organization, or Visa any other third-party payor. Patient is responsible for verifying and understanding the payee on their statement will be Comprehensive Human Services Inc. This limits of his/her coverage, as well as his/her co-payments and deductibles. Therapist is a contracted provider with the name following companies: Beacon Health Strategies, Medi-Cal, Partnership HealthPlan of The Therapist’s CorporationCalifornia, Optum Behavioral Health, Xxxxxx Health Plus, United Behavioral Health , and has agreed to a specified fee. If Patient intends to use benefits of his/her health insurance policy, Patient agrees to inform Therapist in advance.

Client Privilege. The information disclosed by the Client, as well as any records created, is subject to the psychotherapist-client privilege. The psychotherapist-client privilege results from the special relationship between the Therapist and the Client in the eyes of the law. It is akin to the attorney-client privilege or the doctor-patient client privilege. Typically, the Client client is the holder of the psychotherapist-client privilege. If the Therapist received a subpoena for records, deposition testimony, or testimony in a court of law, the Therapist will assert the psychotherapist-client privilege on the Client’s behalf until instructed instructed, in writing writing, to do otherwise by the Client or the Client’s representative. The Client should be aware that he/she might be waiving the psychotherapist- psychotherapist-client privilege if he/she makes his/her mental or emotional state an issue in a legal proceeding. The Client should address any concerns he/she might have regarding the psychotherapist-client privilege with his/her attorney. Fee and Fee Arrangements: Arrangements The fee you are quoted is comparable to most of the Therapists in this area. The Client is expected to pay for services at the time services are rendered. It is asked that you pay your fee at the end of each session. Checks should be made payable to Xxxxxxxx Xxxxx. Please note: The Client is responsible for additional charges as the result of insufficient funds or other payment denial by the client’s bank or credit card institution (Typically $30.00). The usual and customary fee for services service is $195.00 250 per 50-minute sessionsession for individual therapy or couples therapy. Sessions longer than 50 50-minutes are charged for the additional time pro rata (80 minutes @ $290.00)rata. Assessments and Emergency Sessions may be subject to additional fees, which your therapist will advise you of prior to meeting with you. The Therapist reserves the right to periodically adjust feesthis fee. The Client will be notified of any fee adjustment at least 30 days in advance. Your In addition, this fee will may be re-evaluated regularly and also at those times when your financial circumstances changeadjusted by agreement with Therapist. From time-to-time, the Therapist may engage in telephone contact with the Client for purposes other than scheduling sessions. The Client is responsible for payment of the agreed upon fee (on a pro rata basis) for any telephone calls longer than 10 ten minutes. In addition, from time-to- to-time, the Therapist may engage in telephone contact with third parties at the Client’s request and with the Client’s advance written authorization. The Client is responsible for payment of the agreed upon fee (on a pro rata basis) for any telephone calls longer than 10 ten minutes. If the Client chooses Clients are expected to pay by Mastercard or Visa for services at the payee on their statement will be Comprehensive Human Services Inc. This is the name of The Therapist’s Corporationtime services are rendered. Therapist accepts cash and personal checks as well as credit cards. Clients may not use credit cards for reduced fee sessions.

Client Privilege. The information disclosed by the Client, as well as any records created, is subject to the psychotherapist-client privilege. The psychotherapist-client privilege results from the special relationship between the Therapist and the Client in the eyes of the law. It is akin to the attorney-client privilege or the doctor-patient privilege. Typically, the Client is the holder of the psychotherapist-client privilege. If the Therapist received a subpoena for records, deposition testimony, or testimony in a court of law, the Therapist will assert the psychotherapist-client privilege on the Client’s behalf until instructed in writing to do otherwise by the Client or the Client’s representative. The Client should be aware that he/she might be waiving the psychotherapist- client privilege if he/she makes his/her mental or emotional state an issue in a legal proceeding. The Client should address any concerns he/she might have regarding the psychotherapist-client privilege with his/her attorney. Fee and Fee Arrangements: The fee you are quoted is comparable to most of the Therapists in this area. The Client is expected to pay for services at the time services are rendered. It is asked that you pay your fee at the end of each session. Checks should be made payable to Xxxxxxxx Xxxxx. Please note: The Client is responsible for additional charges as the result of insufficient funds or other payment denial by the client’s bank or credit card institution (Typically $30.00). The fee for services is $195.00 190.00 per 50-minute session. Couples Counseling is $190.00 per 50-minute session. Sessions longer than 50 minutes are charged for the additional time pro rata (80 minutes @ $290.00)285.00) Family sessions are 80 minutes @ $285.00 per session. Assessments and Emergency Sessions may be subject to additional fees, which your therapist will advise you of prior to meeting with you. The Therapist reserves the right to periodically adjust fees. The Client will be notified of any fee adjustment at least 30 days in advance. Your fee will be re-evaluated regularly and also at those times when your financial circumstances change. From time-to-time, the Therapist may engage in telephone contact with the Client for purposes other than scheduling sessions. The Client is responsible for payment of the agreed upon fee (on a pro rata basis) for any telephone calls longer than 10 minutes. In addition, from time-to- time, the Therapist may engage in telephone contact with third parties at the Client’s request and with the Client’s advance written authorization. The Client is responsible for payment of the agreed upon fee (on a pro rata basis) for any telephone calls longer than 10 minutes. If the Client chooses to pay by Mastercard or Visa the payee on their statement will be Comprehensive Human Services Inc. This is the name of The Therapist’s Corporation.

Client Privilege. The information disclosed by the Client, as well as any records created, is subject to the psychotherapist-client Client privilege. The psychotherapist-client Client privilege results from the special relationship between the Therapist and the Client in the eyes of the law. It is akin to the attorney-client privilege or the doctor-patient Client privilege. Typically, the Client is the holder of the psychotherapist-client psychotherapist- Client privilege. If the Therapist received a subpoena for records, deposition testimony, or testimony in a court of law, the Therapist will assert the psychotherapist-client Client privilege on the Client’s behalf until instructed instructed, in writing writing, to do otherwise by a person with the authority to waive the privilege on Client's behalf. When a Client is a minor child, the holder of the psychotherapist-Client privilege is either the minor, a court appointed guardian, or a minor's counsel. Parents typically do not have the authority to waive the psychotherapist-Client privilege for their minor children, unless given such authority by a court of law. Representative is encouraged to discuss any concerns regarding the psychotherapist-Client privilege with his/her attorney. Client’s representative. The Client , or Representative, should be aware that he/she might be waiving the psychotherapist- client psychotherapist-Client privilege if he/she makes his/her mental or emotional state an issue in a legal proceeding. The Client Client, or Representative, should address any concerns he/she might have regarding the psychotherapist-client psychotherapist- Client privilege with his/her attorney. Fee and Fee Arrangements: Arrangements The fee you are quoted is comparable to most of the Therapists in this area. The Client is expected to pay for services at the time services are rendered. It is asked that you pay your fee at the end of each session. Checks should be made payable to Xxxxxxxx Xxxxx. Please note: The Client is responsible for additional charges as the result of insufficient funds or other payment denial by the client’s bank or credit card institution (Typically $30.00). The usual and customary fee for services service is $195.00 130 per 50-minute sessionsession of Individual Therapy and Family Therapy. Sessions longer than 50 50-minutes are charged for the additional time pro rata (80 minutes @ $290.00)rata. Assessments Most of the work Therapist does with a minor child is going to be in the Family Therapy format, and Emergency Sessions may be subject to additional feessplit with the Client and Representatives, which your therapist and/or Client together with Representatives and other family members. These sessions will advise you of prior to meeting with youall be billed as Family Therapy. The Therapist reserves the right to periodically adjust feesthis fee. The Client Representative will be notified of any fee adjustment at least 30 days in advance. Your In addition, this fee may be adjusted by contract with insurance companies, managed care organizations, or other third-party payors, or by agreement with Therapist. The agreed upon fee between Therapist and Representative is [insert usual and customary fee, or other agreed upon fee] . Therapist reserves the right to periodically adjust fee. Representative will be re-evaluated regularly and also at those times when your financial circumstances changenotified of any fee adjustment in advance. From time-to-time, the Therapist may engage in telephone contact with the Client or Representative for purposes other than scheduling sessions. The Client Representative is responsible for payment of the agreed upon fee (on a pro rata basis) for any telephone calls longer than 10 fifteen minutes. In addition, from time-to- to-time, the Therapist may engage in telephone contact with third parties at the Client’s request of Client or Representative and with the Client’s advance written authorizationauthorization of Client or Representative. The Client Representative is responsible for payment of the agreed upon fee (on a pro rata basis) for any telephone calls longer than 10 fifteen minutes. If the Client chooses Representative is expected to pay by Mastercard or Visa for services at the payee on their statement time services are rendered. Therapist accepts cash, checks, and major credit cards, including Visa, Mastercard, Discover, and American Express. There will be Comprehensive Human Services Inc. This is the name a $25 fee assessed on all returned or cancelled checks. If Representative has a returned or cancelled check, Therapist may request that Representative use a different method of The Therapist’s Corporationpayment for future services.