Common use of Subpoena of a court Clause in Contracts

Subpoena of a court. If you become involved in a court case or proceeding, you can prevent me from testifying in court about what you have told me. This is called “privilege’ and it is your choice to prevent me from testifying or allow me to do so. It is conceivable, however, that in some situations a judge or a court may require me to testify regardless of your non-consent.  Vulnerable Adult and Position of Authority: I may make a report to the appropriate licensure board or governing authority if a person responsible for the care of vulnerable people (a medical or mental health professional, lawyer, or pastor, for example) is being sexually inappropriate with those under his/her care. I will make a determination about reporting on a case by case basis. Finally, I may occasionally find it helpful to consult other professionals about a case. During a consultation, I make every effort to avoid revealing the identity of my patient. The consultant is also legally bound to keep the information confidential. If you don’t object, I will not tell you about these consultations unless I feel that it is important to our work together. Fees and Cancellation Policies Our first few sessions are evaluation times for both of us. During this time, we can both decide if I am the best person to provide the services you need in order to meet your treatment goals. Standard fee applies for these sessions. If psychotherapy is begun, we will schedule sessions at the 50-minute session per week at a time we agree on. My fee for an individual 50-minute session is $105 and for a family or couple session is $115. Full payment is due at the end of session, and may be paid by cash, checks written to Center for Healing, or by credit/debit card. Unless otherwise agreed upon, if fees are not paid for two sessions, no further sessions will be scheduled until account is brought up to date. Once an appointment is scheduled, you will be expected to pay for it unless you provide 24 hours advance notice of cancellation, or unless we both agree that you were unable to attend due to circumstances beyond your control. Please provide a debit/credit card number below the signature line in this document. It is my desire that no person be denied counseling services due to a lack of financial resources. If you have a need, please speak with me during your first counseling appointment. I have a limited number of slots available for clients on a sliding scale basis and I am happy to work with you to make therapy possible for you with your current financial resources. I can also provide referrals to lower-cost therapy resources that may be options for you. Contacting Me The number you can use to contact me is 000-000-0000. I am often not immediately available by telephone. When I am unavailable, my telephone is answered by a confidential voice mailbox that I monitor frequently. I will make every effort to return your call within 24 hours, with the exception of weekends and holidays. If you are difficult to reach, please inform me of some times when you will be available. For scheduling purposes, you can use the online link to Genbook to make appointments with me. You can also text or email me regarding appointments, however both of these options are not to be used for therapy, 'quick' advice giving or processing a session. Please journal these insights and bring them to the next session. I am available by phone for a fee of $15 for every quarter hour if you need extra time each week. If you are unable to reach me and feel that you can’t wait for me to return your call, contact your family physician, call 911, or visit the nearest emergency room and ask for the psychologist or psychiatrist on call. If I will be unavailable for an extended time, I will provide you with the name of a colleague to contact, if necessary. Professional Records The laws and standards of my profession require that I keep treatment records. You are entitled to receive a copy of your records in the form of a summary. Because these are professional records, they can be misinterpreted and/or upsetting to untrained readers. If you wish to see your records, I recommend that you review them in my presence so that we can discuss the contents. Patients will be charged an appropriate fee for any professional time spent in responding to information requests.

Subpoena of a court. If you become involved in a court case or proceeding, you can prevent me from testifying in court about what you have told me. This is called “privilege’ and it is your choice to prevent me from testifying or allow me to do so. It is conceivable, however, that in some situations a judge or a court may require me to testify regardless of your non-consent.  Vulnerable Adult and Position of Authority: I may make a report to the appropriate licensure board or governing authority if a person responsible for the care of vulnerable people (a medical or mental health professional, lawyer, or pastor, for example) is being sexually inappropriate with those under his/her care. I will make a determination about reporting on a case by case basis. Finally, I may occasionally find it helpful to consult other professionals about a case. During a consultation, I make every effort to avoid revealing the identity of my patient. The consultant is also legally bound to keep the information confidential. If you don’t object, I will not tell you about these consultations unless I feel that it is important to our work together. Fees and Cancellation Policies Our first few sessions are evaluation times for both of us. During this time, we can both decide if I am the best person to provide the services you need in order to meet your treatment goals. Standard fee applies for these sessions. If psychotherapy is begun, we will schedule sessions at the 50-minute session per week at for 50 minutes on a date/time that we agree on. My fee for an individual 50-minute session is $105 100.00 and for a family or couple session is $115110.00. Full payment is due at the end of session, session and may be paid by cash, checks written to Center for HealingPeaceful Connections, LLC, or by credit/debit carddebit/HSA card (a $3.00 processing fee will apply). If our session goes over an hour, each 15 minutes is an addition $25. Unless otherwise agreed upon, if fees are not paid for two sessions, no further sessions will be scheduled until account is brought up to date. Once an appointment is scheduled, you will be expected to pay for it unless you provide 24 hours advance notice of cancellation, cancellation or unless we both agree that you were unable to attend due to circumstances beyond your control. Please provide a debit/credit card number below the signature line in this document. It is my desire that no person be denied counseling services due to a lack of financial resources. If you have a need, please speak with me during your first counseling appointment. I have a limited number of slots available for clients on a sliding scale basis and I am happy to work with you to make therapy possible for you with your current financial resources. I can also provide referrals to lower-cost therapy resources that may be options for you. Contacting Me The number you can use to contact me is (000-) 000-0000. I am often not immediately available by telephone. When I am unavailable, unavailable my telephone is answered by a confidential voice mailbox that I monitor frequently. I will make every effort to return your call within 24 hours, with the exception of weekends and holidays. If you are difficult to reach, please inform me of some times when you will be available. For scheduling purposes, you can use the online link to Genbook to make appointments with me. You can also text or email me regarding appointments, however both of these options are not to be used for therapy, 'quick' advice giving or processing a session. Please journal these insights and bring them to the next session. I am available by phone for a fee of $15 for every quarter hour if you need extra time each week. If you are unable to reach me and feel that you can’t wait for me to return your call, contact your family physician, call 911, or visit the nearest emergency room and ask for the psychologist or psychiatrist on call. If I will be unavailable for an extended time, I will provide you with the name of a colleague to contact, if necessary. Professional Records The laws and standards of my profession require that I keep treatment records. You are entitled to receive a copy of your records in the form of a summary. Because these are professional records, they can be misinterpreted and/or upsetting to untrained readers. If you wish to see your records, I recommend that you review them in my presence so that we can discuss the contents. Patients will be charged an appropriate fee for any professional time spent in responding to information requests.

Subpoena of a court. If you become involved in a court case or proceeding, you can prevent me from testifying in court about what you have told me. This is called “privilege’ and it is your choice to prevent me from testifying or allow me to do so. It is conceivable, however, that in some situations a judge or a court may require me to testify regardless of your non-consent.  Vulnerable Adult and Position of Authority: I may make a report to the appropriate licensure board or governing authority if a person responsible for the care of vulnerable people (a medical or mental health professional, lawyer, or pastor, for example) is being sexually inappropriate with those under his/her care. I will make a determination about reporting on a case by case basis. Finally, I may occasionally find it helpful to consult other professionals about a case. During a consultation, I make every effort to avoid revealing the identity of my patient. The consultant is also legally bound to keep the information confidential. If you don’t object, I will not tell you about these consultations unless I feel that it is important to our work together. Fees and Cancellation Policies Our first few sessions are evaluation times for both of us. During this time, we can both decide if I am the best person to provide the services you need in order to meet your treatment goals. Standard fee applies for these sessions. If psychotherapy is begun, we will schedule sessions at the 50the50-minute session per week at a time we agree on. My fee for an individual 50-minute session is $105 and for a family or couple session is $115. Full payment is due at the end of session, and may be paid by cash, checks written to Center for Healing, or by credit/debit card. Unless otherwise agreed upon, if fees are not paid for two sessions, no further sessions will be scheduled until account is brought up to date. Once an appointment is scheduled, you will be expected to pay for it unless you provide 24 hours advance notice of cancellation, or unless we both agree that you were unable to attend due to circumstances beyond your control. Please provide a debit/credit card number below the signature line in this document. It is my desire that no person be denied counseling services due to a lack of financial resources. If you have a need, please speak with me during your first counseling appointment. I have a limited number of slots available for clients on a sliding scale basis and I am happy to work with you to make therapy possible for you with your current financial resources. I can also provide referrals to lower-cost therapy resources that may be options for you. Contacting Me The number you can use to contact me is 000-000-0000. I am often not immediately available by telephone. When I am unavailable, my telephone is answered by a confidential voice mailbox that I monitor frequently. I will make every effort to return your call within 24 hours, with the exception of weekends and holidays. If you are difficult to reach, please inform me of some times when you will be available. For scheduling purposes, you can use the online link to Genbook to make appointments with me. You can also text or email me regarding appointments, however both of these options are not to be used for therapy, 'quick' advice giving or processing a session. Please journal these insights and bring them to the next session. I am available by phone for a fee of $15 for every quarter hour if you need extra time each week. If you are unable to reach me and feel that you can’t wait for me to return your call, contact your family physician, call 911, or visit the nearest emergency room and ask for the psychologist or psychiatrist on call. If I will be unavailable for an extended time, I will provide you with the name of a colleague to contact, if necessary. Professional Records The laws and standards of my profession require that I keep treatment records. You are entitled to receive a copy of your records in the form of a summary. Because these are professional records, they can be misinterpreted and/or upsetting to untrained readers. If you wish to see your records, I recommend that you review them in my presence so that we can discuss the contents. Patients will be charged an appropriate fee for any professional time spent in responding to information requests.

Subpoena of a court. If you become involved in a court case or proceeding, you can prevent me from testifying in court about what you have told me. This is called “privilege’ and it is your choice to prevent me from testifying or allow me to do so. It is conceivable, however, that in some situations a judge or a court may require me to testify regardless of your non-consent.  Vulnerable Adult and Position of Authority: I may make a report to the appropriate licensure board or governing authority if a person responsible for the care of vulnerable people (a medical or mental health professional, lawyer, or pastor, for example) is being sexually inappropriate with those under his/her care. I will make a determination about reporting on a case by case basis. Finally, I may occasionally find it helpful to consult other professionals about a case. During a consultation, I make every effort to avoid revealing the identity of my patient. The consultant is also legally bound to keep the information confidential. If you don’t object, I will not tell you about these consultations unless I feel that it is important to our work together. Fees and Cancellation Policies Our first few sessions are evaluation times for both of us. During this time, we can both decide if I am the best person to provide the services you need in order to meet your treatment goals. Standard fee applies for these sessions. If psychotherapy is begun, we will schedule sessions at the 50-minute session per week at for 50 minutes on a date/time that we agree on. My fee for an individual 50-minute session is $105 90 and for a family or couple session is $115100. Full payment is due at the end of session, session and may be paid by cash, checks written to Center for HealingPeaceful Connections, LLC, or by credit/debit cardcard (a $3.00 processing fee will apply). If our session goes over an hour, each 15 minutes is an addition $25. Unless otherwise agreed upon, if fees are not paid for two sessions, no further sessions will be scheduled until account is brought up to date. Once an appointment is scheduled, you will be expected to pay for it unless you provide 24 hours advance notice of cancellation, or unless we both agree that you were unable to attend due to circumstances beyond your control. Please provide a debit/credit card number below the signature line in this document. It is my desire that no person be denied counseling services due to a lack of financial resources. If you have a need, please speak with me during your first counseling appointment. I have a limited number of slots available for clients on a sliding scale basis and I am happy to work with you to make therapy possible for you with your current financial resources. I can also provide referrals to lower-cost therapy resources that may be options for you. Contacting Me The number you can use to contact me is (000-) 000-0000. I am often not immediately available by telephone. When I am unavailable, unavailable my telephone is answered by a confidential voice mailbox that I monitor frequently. I will make every effort to return your call within 24 hours, with the exception of weekends and holidays. If you are difficult to reach, please inform me of some times when you will be available. For scheduling purposes, you can use the online link to Genbook to make appointments with me. You can also text or email me regarding appointments, however both of these options are not to be used for therapy, 'quick' advice giving or processing a session. Please journal these insights and bring them to the next session. I am available by phone for a fee of $15 for every quarter hour if you need extra time each week. If you are unable to reach me and feel that you can’t wait for me to return your call, contact your family physician, call 911, or visit the nearest emergency room and ask for the psychologist or psychiatrist on call. If I will be unavailable for an extended time, I will provide you with the name of a colleague to contact, if necessary. Professional Records The laws and standards of my profession require that I keep treatment records. You are entitled to receive a copy of your records in the form of a summary. Because these are professional records, they can be misinterpreted and/or upsetting to untrained readers. If you wish to see your records, I recommend that you review them in my presence so that we can discuss the contents. Patients will be charged an appropriate fee for any professional time spent in responding to information requests.