Common use of TELEPHONE & EMERGENCY PROCEDURES Clause in Contracts

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx between sessions, please leave a message at the answering service (000-000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx checks her messages a few times during the daytime only, unless she is out of town and will return your call within 24 hours. If an emergency situation and you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may call 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, or go immediately to your local hospital emergency room. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to check her email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; at the end of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx if any problems arise 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, Xxxxxxxxx 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 & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx between sessions, please leave a message at the answering service (000-) 000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx checks her messages a few times during the daytime only, unless she is out of town town, and will return your call within 24 hours. If it is an emergency situation and you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may call 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, or go immediately to your local hospital emergency room. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to check her email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 200.00 per 90 minute session (for individual) or $250 250.00 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 125.00 per 45 minutes (individual), 150 $160.00 per 60 for minutes (individual) or ), and $150.00 per 45 minutes for (couple) and 175 185.00 per 60 minutes (couple and family) session; at the end of each session or at the end of the month unless other arrangements have been made. When clients are being seen by an Associate level therapists the cost for initial appointment, intake assessment fee of $175.00 per 90 minute session (individual) or $200.00 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $100.00 per 45 minutes (individual), $130.00 per 60 minutes (individual), and $150.00 per 60 minutes (couple and family) session. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. ., will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx if any problems arise 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 companiescompany. Unless otherwise agreed upon differentlyupon, Xxxxxxxxx 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, section Health Insurance & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx can may use legal or other means (courts, collection agencies, etc.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx Xx. XxXxxxxxx between sessions, please leave a message at the answering service on his confidential voice mail-box (000-) 000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx Xx. XxXxxxxxx checks her his messages a few times during the daytime onlya day, unless she he is out of town and will return your call within 24 hourstown. If an emergency situation and arises, please indicate it clearly in your message. If you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reachedneed to talk to someone right away, you may can call 911Xx. Xxxxx Xxxxxxxx at (000) 000-0000, or the Orange County 24-Hour Crisis Hotlines – National 1-800-273-TALK hour crisis hot line (8255000) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, or go immediately to your local hospital emergency room. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to check her email or faxes dailyPolice (911). PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 $ per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; 55 minute session at the end of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, report writing and reading of reportsreading, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. ... will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx Xx. XxXxxxxxx if any problems arise 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 companiescompany. Unless agreed upon differently, Xxxxxxxxx Xxxxx Xx. XxXxxxxxx will provide you with a copy of your receipt on a monthly basis, which you can then submit to your insurance company for reimbursement, reimbursement if you so choose. As was indicated in the section, section Health Insurance & Confidentiality confidentiality of Recordsrecords, you must be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk. Not all issues/conditions/problems, which are dealt with in the focus of psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx Xx. Xxxxxxx between sessions, please leave a message at on the answering service voicemail (000-000-0000 415­754­0451) and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx Xx. Xxxxxxx checks her his messages on a few times during the daytime onlydaily basis, unless she he is out of town and will return your call within 24 town; he generally returns messages during normal work hours. If an emergency situation and you are arises, please indicate it clearly in your message. In case of a crisis situationmental health crisis, and Xxxxxxxxx Xxxxx cannot be reached, you may call 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, or go immediately please refer to your local hospital emergency room. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out one of the office 24/7 crisis call centers, 1­800­273­8255 or on vacation and may be unable to check her email or faxes daily415­781­0500. PAYMENTS & INSURANCE REIMBURSEMENTIn case of other of emergencies needing immediate attention please contact 911 for assistance. PSYCHOTHERAPY CHARGES: Clients are expected to pay at initial appointment an intake assessment the agreed upon fee of $200 per 90 for each 50 minute session (therapy session. For clients using insurance, you are responsible for individual) or $250 for 90 minute session per couple or familycopayment and updating any changes to your insurance plan. Clients are expected to pay the standard fee of $120.00 per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; at the end of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. The client will be charged the full fee without a 48­hour­notice of cancellation, with the exception of emergencies. If you are a student or sliding fee agreement you will be charged that rate. If you are a client covered by insurance, you will be charged the standard rate. Sliding Fee rate: Standard Rate: Intial: MEDIATION & ARBITRATION: All disputes arising out of or in relation to their agreement to provide psychotherapy services shall first be referred to mediation, before, and as a pre­condition of, the initiation of arbitration. The mediator shall be a neutral third party chosen by agreement of Xx. Xxxxxxx 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 ther agreement should be submitted to and settled by binding arbitration in Sacramento County, California in accordance with the rules of the American Arbitration Association which are in effect at the same ratetime the demand for arbitration is filed. Notwithstanding the foregoing, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx if any problems arise 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, Xxxxxxxxx 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 & Confidentiality of Records, you must be aware event that submitting a mental health invoice for reimbursement carries a certain amount of risk. Not all issues/conditions/problems, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx Xx. Xxxxxxx can use legal or other means (courtscourt, collection agenciesagency, etc.) to obtain payment. The prevailing party in arbitration or collection proceeding shall be entitled to recover a reasonable sum as well as attorneys’ fees. In the case of arbitration, the arbitrator will determine that sum.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx Xxxxxx Xxxxxxx Xxxxxxx: LCSW, CRC between sessions, please leave a message on Xxxxxx Xxxxxxx Xxxxxxx: LCSW, CRC’s confidential voice mail at the answering service (000-) 000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx Xxxxxx Xxxxxxx Xxxxxxx: LCSW, CRC checks her messages a few times during the daytime only, unless she is out of town and will return your call within 24 hourstown. If an emergency situation arises, indicate it clearly in your message and if you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may need to talk to someone right away call 911, or Portland’s 24-Hour Crisis Hotlines – National 1-800-273-TALK hour crisis line (8255000) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, or go immediately to your local hospital emergency roomthe Police: 911. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a clientXxxxxx Xxxxxxx Xxxxxxx: LCSW, out of the office or on vacation and may be unable to CRC does not always check her email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 per 140.00per 45 minutes (individual), 150 per 60 for (individual) minute or $150.00 150.00xx per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; one hour session at the end beginning of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx Xxxxxx Xxxxxxx Xxxxxxx: LCSW, CRC if any problems arise 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, Xxxxxxxxx Xxxxx Xxxxxx Xxxxxxx Xxxxxxx: LCSW, CRC 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 & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx Xxxxxx Xxxxxxx Xxxxxxx: LCSW, CRC can use legal or other means (courts, collection agencies, etc.) to obtain payment. MEDIATION & ARBITRATION: All disputes arising out of, or in relation to, this agreement to provide psychotherapy services shall first be referred to mediation, before, and as a pre- condition of, the initiation of arbitration. The mediator shall be a neutral third party chosen by agreement of Xxxxxx Xxxxxxx Xxxxxxx: LCSW, CRC and the client(s). The cost of such mediation, if any, shall be split equally, unless otherwise agreed upon. In the event that mediation is unsuccessful, any unresolved controversy related to this agreement should be submitted to and settled by binding arbitration in Multnomah County, Portland, Oregon, in accordance with the rules of the American Arbitration Association which 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, Xxxxxx Xxxxxxx Xxxxxxx: LCSW, CRC 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 as and for attorney's fees. In the case of arbitration, the arbitrator will determine that sum. THE PROCESS OF THERAPY/EVALUATION AND SCOPE OF PRACTICE: 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. Xxxxxx Xxxxxxx Xxxxxxx: LCSW, CRC 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 you experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, etc., or experiencing anxiety, depression, insomnia, etc. Xxxxxx Xxxxxxx Xxxxxxx: LCSW, CRC may challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations, which 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, Xxxxxx Xxxxxxx Xxxxxxx: LCSW, CRC, is likely to draw on various psychological approaches according, in part, to the problem that is being treated and her assessment of what will best benefit you. These approaches include, but are not limited to, behavioral, cognitive-behavioral, cognitive, psychodynamic, system/family, developmental (adult, child, family), humanistic, brief Solution Focused, Strength-Based or psycho-educational Therapy techniques. Xxxxxx Xxxxxxx Xxxxxxx: LCSW, CRC provides neither custody evaluation recommendation nor medication or prescription recommendation nor legal advice, as these activities do not fall within her scope of practice.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxxxxx Xxxxxx Xxxxxxx Xxxxx between sessions, please leave a message at the on her answering service machine (000-000-831) 000- 0000 and your call will be returned as soon as possible. Xxxxxxxxx You may also send an email to XxxxxxxxXxxxxXXX@xxxxx.xxx and text to: 000-000-0000. Xxxxxxxx Xxxxxx Xxxxxxx Xxxxx checks her messages a few times during the daytime only, unless she s/he is out of town and will return your call within 24 hourstown. If an emergency situation arises, indicate it clearly in your message and if you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may need to talk to someone right away call 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK Psychiatric Emergency Services. Santa Xxxx: (8255000) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, 24-hour crisis line for Santa Xxxx, or go immediately to your local hospital emergency roomthe Police: 911. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxxxxx Xxxxxx Xxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to does not always check her email or faxes dailydaily and must turn on a machine to receive them. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 150.00 per 45 minutes (individual), 150 per 60 for (individual) 45-50 minute or $150.00 180.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) hour session at the beginning of each session; at the end of each session or at the end of the month unless other arrangements have been madeadd $5 if paying by credit card. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxxxxx Xxxxxx Xxxxxxx Xxxxx if any problems arise 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, Xxxxxxxxx Xxxxxxxx Xxxxxx Xxxxxxx 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 & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxxxxx Xxxxxx Xxxxxxx Xxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx Xxxxxxx Xxxxxxx between sessions, please leave a message at the answering service (000-) 000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx Xxxxxxx Xxxxxxx checks her messages a few times during the daytime only, unless she is out of town and will return your call within 24 hourstown. If an emergency situation arises, indicate it clearly in your message and if you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may need to talk to someone right away call 911, or the 24-Hour Crisis Hotlines – National 1-800-273-TALK hour crisis line (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa San Diego): 0-000-000-0000 or 000-000-0000, or go immediately to your local hospital emergency roomthe Police: 911. Please do not use email email, text messages or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to Xxxxxxx Xxxxxxx does not always check her email or faxes daily. PAYMENTS Records and Your Right To Review Them: Both the law and the standards of Xxxxxxx Xxxxxxx’x profession require that she keep treatment records for at least 7 years. Unless otherwise agreed to be necessary, Xxxxxxx Xxxxxxx retains clinical records only as long as is mandated by California law. If you have concerns regarding the treatment records, please discuss them with Xxxxxxx Xxxxxxx. As a client, you have the right to review or receive a summary of your records at any time, except in limited legal or emergency circumstances or when Xxxxxxx Xxxxxxx assesses that releasing such information might be harmful in any way. In such a case, Xxxxxxx Xxxxxxx will provide the records to an appropriate and legitimate mental health professional of your choice. Considering all of the above exclusions, if it is still appropriate, and upon your request, Xxxxxxx Xxxxxxx will release information to any agency/person you specify unless Xxxxxxx Xxxxxxx assesses that releasing such information might be harmful in any way. When more than one client is involved in treatment, such as in cases of couple and family therapy, Xxxxxxx Xxxxxxx will release records only with signed authorizations from all the adults (or all those who legally can authorize such a release) involved in the treatment. Payments & INSURANCE REIMBURSEMENTInsurance Reimbursement: Clients are expected to pay the agreed upon fee at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; at the end of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx Xxxxxxx Xxxxxxx if any problems arise 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 differentlyIf requested, Xxxxxxxxx Xxxxx Xxxxxxx Xxxxxxx will provide you with a copy of your receipt statement 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 & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx Xxxxxxx Xxxxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment. Mediation & Arbitration: All disputes arising out of, or in relation to, this agreement to provide psychotherapy, psychoeducational, consulting or assessment services shall first be referred to mediation, before, and as a pre-condition of, the initiation of arbitration. The mediator shall be a neutral third party chosen by agreement of Xxxxxxx Xxxxxxx and the client(s). The cost of such mediation, if any, shall be split equally, unless otherwise agreed upon. In the event that mediation is unsuccessful, any unresolved controversy related to this agreement should be submitted to and settled by binding arbitration in San Diego County, CA in accordance with the rules of the American Arbitration Association which 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, Xxxxxxx Xxxxxxx 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 as and for attorney's fees. In the case of arbitration, the arbitrator will determine that sum. The Process of Therapy/Evaluation and Scope of Practice: 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. Xxxxxxx Xxxxxxx 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 you experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, etc., or experiencing anxiety, depression, insomnia, etc. Xxxxxxx Xxxxxxx may challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations, which 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, Xxxxxxx Xxxxxxx is likely to draw on various psychological approaches according, in part, to the problem that is being treated and her assessment of what will best benefit you. These approaches include, but are not limited to, behavioral, cognitive-behavioral, cognitive, psychodynamic, existential, system/family, developmental (adult, child, family), EMDR, Lifespan Integration, humanistic or psycho-educational. Xxxxxxx Xxxxxxx provides neither custody evaluation recommendations nor medication or prescription recommendations nor legal advice, as these activities do not fall within her scope of practice.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx Xxxxxxxx between sessions, please leave a message at the answering service (000-000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx Xxxxxxxx checks her messages a few times during the daytime only, unless she is out of town and will return your call within 24 hourstown. If an emergency situation arises, indicate it clearly in your message and if you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may need to talk to someone right away call 911, or the 24-Hour Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 hour crisis line or 000-000-0000, or go immediately to your local hospital emergency roomthe Police: 911. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to check her email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 100.00 per 45 minutes (individual), 150 per 60 for (individual) minute or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; hour session at the end of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx Xxxxxxxx if any problems arise 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, Xxxxxxxxx differently Xxxxx Xxxxxxxx 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 & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx Xxxxxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx Xxx Xxxxxxx, MFT between sessions, please leave a message at on the answering service of Xxx Xxxxxxx, MFT (000-) 000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx Xxx Xxxxxxx, MFT checks her his messages a few times during the daytime onlya day, unless she he is out of town and will return your call within 24 hourstown. If an emergency situation and arises, please indicate it clearly in your message. If you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reachedneed to talk to someone right away, you may can call 911, or Xxxxx Xxxx’x 24-Hour Crisis Hotlines – National 1-800-273-TALK hour crisis line at (8255000) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, or go immediately to your local hospital emergency room. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to check her email or faxes dailyPolice (911). PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; 55 minute session at the end beginning of each session or at the end of the month unless other arrangements have been madesession. The fee my be increased moderately from time to time. Telephone conversations, site visits, report writing and reading of reportsreading, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx Xxx Xxxxxxx, MFT if any problems arise 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 companiescompany. Unless agreed upon differently, Xxxxxxxxx Xxxxx Xxx Xxxxxxx, MFT will provide you with a copy of your receipt on a monthly basis, which you can then submit to your insurance company for reimbursement, reimbursement if you so choose. As was indicated in the section, section Health Insurance & Confidentiality confidentiality of Recordsrecords, you must be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk. Not all issues/conditions/problems, which are dealt with in the focus of psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx Xxxx Xxxxxx, LPC between sessions, please leave a message at the answering service (000-000-0000 602) 734- 0192 or email (preferred) and your call message will be returned as soon as possible. Xxxxxxxxx Xxxxx Xxxx Xxxxxx, LPC checks her messages a few times during the daytime only, unless she is out of town and will return your call within 24 hourstown, on vacation, and/or not scheduled to work. If an emergency situation arises, indicate it clearly in your message and if you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may need to talk to someone right away call 911, Psychiatric or 24-Hour Crisis Hotlines – National 1-800-273-TALK Behavioral/Mental Health Emergency Services. (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-County): 000-000-0000 (24-hour crisis line) (Phoenix area) or 000-000-0000, or go immediately to your local hospital emergency roomthe Police: 911. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a clientXxxx Xxxxxx, out of the office or on vacation and may be unable to LPC does not always check her email email, voice messages, or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 165 for intakes, $130 per 45 minutes (individual), 150 per 60 for (individual) minute therapy session or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; hour therapy session at the end of each session or at the end of the month prior to each session unless other arrangements have been made. Hypnotherapy is $165. The fees are standard for therapy unless other fees have been agreed upon by both Xxxx Xxxxxx and the client such as in the case of financial hardship. The no-show fee, missed appointment or late cancellation fee with under 24 hours notice is the full session fee or minimum of $75 unless other arrangements were made. Xxxx Xxxxxx, LPC may automatically charge your card on file for missed/late cancel/or no-shows appointment unless other arrangements have been agreed upon between you and Xxxx Xxxxxx, LPC. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx Xxxx Xxxxxx, LPC if any problems arise 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 companiescompanies if not contracted with Kara. Unless agreed upon differentlyXxxx Xxxxxx, Xxxxxxxxx Xxxxx LPC will provide you with a copy of your receipt on a monthly basis, per your request which you can then submit to your insurance company for reimbursement, if you so choose. IF Xxxx Xxxxxx, LPC is contracted by insurance companies to bill an insurance panel directly, then Xxxx will collect your co-pay or deductible. If Xxxx Xxxxxx, LPC bills insurance for you as a courtesy, she may hire a medical xxxxxx to assist in this billing insurance process. This medical xxxxxx is trained in HIPPA and client confidentiality. As was indicated in the section, Health Insurance & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx Xxxx Xxxxxx LPC can use legal terminate therapy. THE PROCESS OF THERAPY/EVALUATION AND SCOPE OF PRACTICE: 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. Xxxx Xxxxxx, LPC 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 other means (courtstherapy, collection agenciesremembering or talking about unpleasant events, feelings, or thoughts can result in you experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, etc., or experiencing anxiety, depression, insomnia, etc. Xxxx Xxxxxx, LPC may challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations, which 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 can also be slow and even frustrating. There is no guarantee that psychotherapy will yield positive or intended results. During the course of therapy, Xxxx Xxxxxx, LPC is likely to draw on various psychological approaches according, in part, to the problem that is being treated and her assessment of what will best benefit you. These approaches include, but are not limited to: Client-centered and Eclectic, Behavioral, Cognitive-Behavioral, Cognitive, Psychodynamic, Existential, Hypnotherapy, System/Family, Developmental (adult, child, family), Humanistic, EMDR (alternating bilateral stimulation for reprocessing), DBT (Dialectical Behavioral Therapy) or psychoeducational. Xxxx Xxxxxx, LPC provides neither custody evaluation recommendations nor medication or prescription recommendations nor legal advice, as these activities do not fall within her scope of practice. Discussing your compliance with medications in the interest of discussing progress may be addressed in session and Xxxx Xxxxxx, LPC advises you to obtain paymentdiscuss all medical and medication management issues with your prescriber.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx me between sessions, please leave a message at the answering service on my voicemail (000-) 000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx checks her I check my messages throughout the day Monday through Thursday, and once a few times during the daytime onlyday on Friday, Saturday and Sunday, unless she is I am out of town and will return your call within 24 hourstown. If an emergency situation and arises, please indicate it clearly in your message. If you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reachedneed to talk to someone right away, you may can call 911, or the 24-Hour Crisis Hotlines – National hour crisis line at 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000833- 2900, or go immediately to your local hospital emergency roomcall the police. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a clientIf I am on vacation, out I always leave the number of the office or psychotherapist who is covering for me on vacation and may be unable to check her email or faxes dailymy voicemail message. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 $ per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; 50 minute session at the end of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, report writing and reading of reportsreading, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx me if any problems arise 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, Xxxxxxxxx Xxxxx 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, reimbursement if you so choose. As was indicated in the section, section Health Insurance & Confidentiality confidentiality of Recordsrecords, you must be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk. Not all issues/conditions/problems, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx I can use legal or other means (courts, collection agencies, etc.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx Xxxx Xxxxxxx, MFT between sessions, please leave a message at the answering service (000-) 000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx Xxxx Xxxxxxx, MFT checks his/her messages a few times during the daytime only, unless she he is out of town and will return your call within 24 hourstown. If an emergency situation arises, indicate it clearly in your message and if you are need to talk to someone right away call San Bernardino County Crisis Walk-in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may call 911, or 24Center M-Hour Crisis Hotlines – National 1-800-273-TALK F (8255000) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 24 Hour (000-) 000-0000, 24-hour crisis line (951) 686- 4357 or go immediately to your local hospital emergency roomthe Police: 911. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a clientXxxx Xxxxxxx, out of the office or on vacation and may be unable to MFT does not always check her his email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 125.00 per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; at 50 minute session before the end beginning of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx Xxxx Xxxxxxx, MFT if any problems arise during the course of therapy regarding your ability to make timely payments. I do not accept regular health insurance or Medi- Cal. 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, Xxxxxxxxx Xxxxx Xxxx Xxxxxxx, MFT 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 & Confidentiality of Records, you must be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk. Not all issues/issues/ conditions/problems, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx Xxxx Xxxxxxx, MFT can use legal or other means (courts, collection agencies, etc.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx Xxx Xxxxxxxxxx between sessions, please leave a message at the answering service (000-) 000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx She checks her messages a few times a day (but never during the daytime onlynight time), unless she is out of town town. She checks the messages less frequently on weekends and will return your call within 24 hoursholidays. If an emergency situation and arises, please indicate it clearly in your message. If you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reachedneed to talk to someone right away, you may can call 911, or the 24-Hour Crisis Hotlines – National 1-800-273-TALK hour crisis line (8255000) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000the Police at: 9-0001-0000, or go immediately to your local hospital emergency room. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to check her email or faxes daily1. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee the standard Fee of $200 160 per 90 minute 50 minutes session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; at the end beginning of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, report writing and reading of reportsreading, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx your therapist if any problems arise 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, Xxxxxxxxx Xxxxx your therapist will provide you with a copy of your receipt on a monthly basis, which you can then submit to your insurance company for reimbursement, reimbursement if you so choose. As was indicated in the section, Health Insurance & 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/problemsproblem, which are dealt with in the focus of psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If THE PROCESS OF THERAPY/EVALUATION: Participation in therapy can result in a number of benefits to you, including improving interpersonal relationship and resolution of the specific concerns that led you to seek therapy. Working toward these benefits; however, requires effort on your account part. Psychotherapy requires a very active involvement, honesty, and openness in order to change your thoughts, feelings and/or behavior. Your therapist 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, etc. or experiencing depression, insomnia, etc. Your therapist 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, employments, substance use, schooling, housing, or relationships. Sometimes a decision that is overdue (unpaid) positive for one family member is viewed quite negatively by another family member. Change will sometimes be easy and there swift, but more often it will be slow and even frustrating. There is no written agreement guarantee that psychotherapy will yield positive or intended results. During the course of therapy, your therapist is likely to draw on various psychological approaches according, in part, to the problem that is being treated and her assessment of what will best benefit you. These approaches include behavioral, cognitive-behavioral, psychodynamics, somatic, transpersonal, system/family, or psycho-educational. Discussion of Treatment Plan: Within a payment reasonable period of time after the initiation of treatment, your therapist will discuss with you (client) her working understanding of the problem, treatment plan, Xxxxxxxxx Xxxxx can use legal therapeutic objectives, and her view of the possible outcomes of treatment. IF you have any unanswered questions about any of the procedures to be used in the course of therapy, their possible risks, your therapist’s expertise in employing them, or about the treatment plan, please and you will be answered fully. You also have the right to ask about other means treatments for your condition and their risks and benefits. If you could benefit from any treatment that your therapist does not provide, she has an ethical obligation to assist you obtaining those treatments. NOTICE TO CLIENTS: The Board of Behavioral Sciences receives and responds to complaints regarding services provided within the scope of practice of (courtsmarriage and family therapists, collection agencieslicensed educational psychologists, etcclinical social workers, or professional clinical counselors). You may contact the board online at xxx.xxx.xx.xxx, or by calling (000) 000-0000.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxxx Xxxxx between sessions, please leave a message at on the answering service (000-000-0000 408) 249-­‐0014 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxxx Xxxxx checks her his messages a few times during the daytime only, unless she he is out of town and will return your call within 24 hourstown. If an emergency situation arises, indicate it clearly in your message and if you are in a crisis situationneed to talk to someone right away call Suicide and Crisis Hot line (Santa Xxxxx County): (408) 279-­‐3312, and Xxxxxxxxx Emergency Psychiatric Services (Santa Xxxxx cannot be reached, you may call County): (408) 885-­‐6100 or the Police: 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, or go immediately to your local hospital emergency room. Please do not use email e-­‐mail or faxes Faxes for emergencies. Xxxxxxxxx Xxxxxx Xxxxx may be with a client, out of the office does not always check his e-­‐mail or on vacation and may be unable to check her email or faxes Faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 225.00 per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; minute at the end beginning of each session by check, cash, or at the end of the month unless other arrangements have been madecredit card. Telephone conversations, site visits, report writing and reading of reportsreading, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxxx Xxxxx if any problems arise during the course of therapy regarding your ability to make timely payments. Clients who carry Upon verification of health plan/insurance should remember that professional services are rendered coverage and charged to the clients and not to the insurance companies. Unless agreed upon differentlypolicy limits, Xxxxxxxxx Xxxxx will provide you with a copy of your receipt on a monthly basis, which you can then submit to your insurance company carrier will be billed for reimbursementyou and your provider will be paid directly by the carrier. The patient/guardian will be responsible for any applicable deductibles and co payments. If you are not eligible at the time of service rendered, if you so chooseare responsible for payment. As was indicated in the section, section Health Insurance & Confidentiality confidentiality of Recordsrecords, you must be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk. Not all issues/conditions/problems, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxxx Xxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx me for an urgent matter between sessions, please leave a message at the answering service call (000-) 000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx checks her messages a few times Non-urgent telephone calls left after 5:00 on weekdays or during the daytime only, unless she is out of town and weekend will return your call within 24 hoursbe returned on the next business day. If a life-threatening emergency arises between sessions, call 911 or go to the nearest emergency room. If there is an emergency situation and while you are a client at Advantage Counseling or in a crisis situationthe future after termination where I become concerned about your personal safety, and Xxxxxxxxx Xxxxx cannot be reached, the possibility of you may call 911injuring someone else, or 24about you receiving proper psychiatric care, I will do whatever I can within the limits of the law, to prevent you from injuring yourself or others and to ensure that you receive the proper medical care. For this purpose, I may also contact the person whose name you have provided on the Client Information Form. The following crisis hotlines may also be utilized in case of an emergency and I am unable to take your call: Battered Person’s 24 Hour Hotline: 000-Hour Crisis Hotlines – National 1000-800-273-TALK 0000 Child Abuse (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa KS): 0-000-000-0000 Child Abuse (MO): 0-000-000-0000 Johnson County Mental Health: 000-000-0000 Rape Crisis Line (KS): 000-000-0000 Rape Crisis Line (MO): 000-000-0000 Suicide Prevention Line: 0-000-000-0000 EMAIL AND TEXTING POLICY: If you need to contact me to schedule or reschedule an appointment, you may do so at xxxx@xxxxxxxxxxxxxxxxxxxxx.xxx or call 000-000-0000. Because Advantage Counseling cannot guarantee confidentiality with email correspondence, it is the policy of Advantage Counseling that no advice or go immediately to your local hospital emergency room. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to check her email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; at the end of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. counseling will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx if any problems arise 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, Xxxxxxxxx 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 & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coveragedone through e-mail. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx can use legal you prefer to communicate regarding scheduling through text messages understand that Advantage Counseling cannot guarantee confidentiality. No advice or other means (courts, collection agencies, etccounseling will be done through text messages.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Dr. Xxxx Xxxxx between sessions, for non-emergency related matters, please leave a message at the answering service on her telephone (000-) 000-0000 and your call will be returned 0000. Xx. Xxxxx returns calls as soon as possible. Xxxxxxxxx Xxxxx checks her messages a few times during the daytime only, always within one business day, unless she is out of town and away from the office. Clients are notified in advance when Xx. Xxxxx will return your call within 24 hoursbe away. If an you are having a psychiatric emergency situation and need law enforcement support call the Police at 911 and ask for a Crisis Intervention Team (CIT) officer. CIT officers have been trained to deal with mental health crises. If you are in a crisis situationpsychiatric emergency, and Xxxxxxxxx Xxxxx canbut do not be reachedneed law enforcement support, you may can call 911, or 24-Hour the Ventura County Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, or go immediately to Team at 1-(866)-998- 2243. They will assess your local hospital emergency roomneeds over the phone and respond accordingly. Please do not use email or faxes for emergencies. Xxxxxxxxx Dr. Xxxx Xxxxx may be with a client, out of the office or on vacation and may be is often unable to check her email or faxes dailyfor many hours at a time. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 185.00 per 45 minutes (individual)55 minutes, 150 per 60 for (individual) or $150.00 275.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; 90-minute session at the end conclusion of each session or at the end of the month unless other arrangements have been madeappointment. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwiserate of $185.00 per hour. Please notify Xxxxxxxxx Dr. Xxxx Xxxxx if any problems arise 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, Xxxxxxxxx Dr. Xxxx 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 & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Dr. Xxxx Xxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment. THE PROCESS OF THERAPY/EVALUATION AND SCOPE OF PRACTICE: 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 for you or your minor children. Working toward these benefits, however, requires effort on your and your young person’s part. Psychotherapy requires clients’ active involvement, honesty, and openness in order to change their thoughts, feelings, and behavior. Dr. Xxxx Xxxxx 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 you experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, etc., or experiencing anxiety, depression, insomnia, etc. Dr. Xxxx Xxxxx may challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations, which 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, other times it will be slow and even frustrating. There is no guarantee that psychotherapy will yield positive or intended results. During the course of therapy, Dr. Xxxx Xxxxx is likely to draw on various psychological approaches according, in part, to the problem that is being treated and her assessment of what will best benefit you and/or your young person. These approaches include, but are not limited to, behavioral, cognitive-behavioral, parent child interaction therapy, cognitive, psychodynamic, existential, system/family, developmental (adult, child, family), humanistic or psycho-educational. Dr. Xxxx Xxxxx provides neither custody evaluation recommendation nor medication or prescription recommendation nor legal advice, as these activities do not fall within her scope of practice.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx Xx. Xxxxxxx between sessions, please leave a message at the answering service on my confidential voicemail. (000-) 000-0000 and text me stating that your call needs are urgent. I will be returned respond as soon as possible. Xxxxxxxxx Xxxxx Xx. Xxxxxxx checks her messages a few times during the daytime only, unless she is out of town and will return your call within 24 hourstown. If an emergency situation arises and you are in a crisis situationneed to talk to someone right away, and Xxxxxxxxx Xxxxx cannot be reached, you may call 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK Psychiatric Emergency Services. Santa Xxxx: (8255000) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 to access a 24-hour crisis line or 000-000-0000, or go immediately to your local hospital emergency roomcall 911. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to Xx. Xxxxxxx does not always check her email or faxes dailyemail. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 165.00 per 45 minutes (individual), 150 per 60 for (individual) 45-minute individual session or $150.00 185.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; couples’ session at the end of each session or at the end Beginning of the month session unless other arrangements have been made. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx Xx. Xxxxxxx if any problems arise 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, Xxxxxxxxx Xxxxx Xx. Xxxxxxx 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 & Confidentiality of Records, you must be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk. Not all issues/issues/ conditions/problems, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx Xx. Xxxxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment. THE PROCESS OF THERAPY EVALUATION AND SCOPE OF PRACTICE: 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. Xx. Xxxxxxx 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 you experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, etc., or experiencing anxiety, depression, insomnia, etc.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx between sessions, please leave a message at the answering service (000-000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx checks her messages a few times during the daytime only, unless she is out of town and will return your call within 24 hours. If an emergency situation and you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may call 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000602-000-0000222- 9444, or go immediately to your local hospital emergency room. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to check her email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 per 45 minutes (individual), 150 140 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; at the end of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx if any problems arise 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, Xxxxxxxxx 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 & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx Xx. Xxxxxx between sessions, please leave a message at with the answering service (000-) 000-0000 number and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx Xx. Xxxxxx checks her messages a few times during the daytime onlya day, unless she is out of town and will return your call within 24 hourstown. If an urgent situation arises, please indicate it clearly in your message and for emergency situation and you are situations, phone ‘911’ in the case of a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may call 911, medical or 24-Hour Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, or go immediately to your local hospital emergency room. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to check her email or faxes dailypsychiatric emergency. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 $ 125.00 per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; 50-minute session at the end of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, report writing and reading of reportsreading, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx Xx. Xxxxxx if any problems arise 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, Xxxxxxxxx Xxxxx Xx. Xxxxxx will provide you with a copy of your receipt on a monthly basis, which you can then submit to your insurance company for reimbursement, reimbursement if you so choose. As was indicated in the section, Health Insurance & 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/problemsissues /conditions /problems, which are dealt with in the focus of psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If MEDIATION & ARBITRATION: All disputes arising out of or in relation to this agreement to provide psychotherapy services shall first be referred to mediation, before, and as a pre-condition of, the initiation of arbitration. The mediator shall be a neutral third party chosen by agreement of Xx. Xxxxxx 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 Los Angeles County, in accordance with the rules of the American Arbitration Association which 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 written agreement on a payment plan, Xxxxxxxxx Xxxxx Xx. Xxxxxx can use legal or other means (courtscourt, collection agenciesagency, 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 arbitrator will determine that sum. 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. Xx. Xxxxxx 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, etc. or experiencing anxiety, depression, insomnia, etc. Xx. Xxxxxx 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, Xx. Xxxxxx 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, solution-focused, system/family, developmental (adult, child, family), or psycho-educational.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx me between sessions, please leave a message at the answering service my confidential voicemail box, (000-) 000-0000 0000, and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx checks her I check my messages a few times during the daytime only, unless she is I am out of town and will return your call within 24 hourstown. If an emergency situation arises, indicate it clearly in your message and if you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may need to talk to someone right away call 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, or go immediately to your local hospital emergency room. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to I don’t always check her email or faxes my emails daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; 50 minute at the end of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx me if any problems arise 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, Xxxxxxxxx Xxxxx I will provide you with a copy of your receipt on a monthly basissuper bill after each session, which you can then submit to your insurance company for reimbursement, if you so choose. As was indicated in the section, Health Insurance & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx I can use legal or other means (courts, collection agencies, etc.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx between sessions, please leave a message at the answering service (000-) 000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx checks her messages a few times during the daytime only, unless she is out of town town, and will return your call within 24 hours. If it is an emergency situation and you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may call 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, or go immediately to your local hospital emergency room. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to check her email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 225.00 per 90 90-minute session (for individual) or $250 250.00 for 90 90-minute session per couple or family. Clients are expected to pay the standard fee of $120.00 130.00 per 45 minutes (individual), 150 $180.00 per 60 for minutes (individual) or ), and $150.00 per 45 minutes for (couple) and 175 225.00 per 60 minutes (couple and family) session; at the end of each session or at the end of the month unless other arrangements have been made. When clients are being seen by an Associate level therapist the cost for initial appointment, intake assessment fee of $200.00 per 90-minute session (individual) or $225.00 for 90- minute session per couple or family. Clients are expected to pay the standard fee of $100.00 per 45 minutes (individual), $130.00 per 60 minutes (individual), and $180.00 per 60 minutes (couple and family) session. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. ., will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx if any problems arise 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 companiescompany. Unless otherwise agreed upon differentlyupon, Xxxxxxxxx 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, section Health Insurance & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx can may use legal or other means (courts, collection agencies, etc.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx me between sessions, please leave a message on my voicemail or a text at the answering service (000-) 000-0000 (not any other number, fax, or email) and I will return your call will be returned as soon as possible. Xxxxxxxxx Xxxxx checks her I respond more quickly to text messages. I try to check messages regularly, unless I am out of town, but I may not always get your message in a few times timely manner. I do not check messages during the daytime only, unless she is out of town night. Messages are checked less frequently on weekends and will return your call within 24 hoursholidays. If an emergency situation and you are arises, please indicate it clearly in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you your message. You may also call 911, or the 24-Hour Crisis Hotlines – National 1-800-273-TALK hour crisis line (8255000) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, or go immediately to your local hospital emergency room. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to check her email or faxes daily911. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 per 45 minutes (individual), 150 per 60 250 for (individual) an intake session and $195 for a regular session or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; their individual deductible and/or co-payment at the end of each session or at the end of the month psychotherapy session, unless other arrangements have been made. Balances over 30 days overdue will be charged late fees of $25/month. Checks are to be made payable to Xxxxxx Xxxxxxx, Ph.D. Telephone conversations, site visits, report-writing and reading of reportsreading, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Court appearances and testimonies are charged at different rates plus travel time/expenses. Please notify Xxxxxxxxx Xxxxx me if any problems arise problem arises during the course of therapy regarding your ability to make timely payments. Clients who If you carry insurance should insurance, please remember that professional services are rendered and charged to the clients you and not to the insurance companies. Unless agreed upon differently, Xxxxxxxxx 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 & Confidentiality of Records, you must be Be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk. Not Insurance companies do not reimburse for all issues/conditions/problems, which problems that are dealt with in the focus of psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coveragecoverage with your insurance company, since ultimately you are financially responsible for sessions not reimbursed by your medical insurance. If We will be happy to bill your account is overdue (unpaid) insurance company; however, if your insurance company does not pay within 60 days or declines to pay, you may be asked to pay a portion or all of your outstanding bill, which will be refunded to you if and there is no written agreement on a payment planwhen your insurance pays. Statements submitted to insurance companies must be billed payable to Xxxxxx Xxxxxxx, Xxxxxxxxx Xxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment.Ph.D.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx the counselor between sessions, please leave a message at on the answering service (000-) 000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx The counselor checks her messages a few times during the daytime only, unless she is out of town town. The counselor is not available for 24 hour a day for crisis telephone calls, emails, or emergencies and will return your call within 24 hoursdoes not use a pager service. If an emergency situation arises indicate it clearly in your message and the counselor will respond as soon as possible. However, If you need to talk to someone right away and are in experiencing an imminent crisis or danger or any other type of emergency that needs an immediate response, call Multnomah County 24 hour a day crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may call 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or line at 000-000-0000, your primary care physician, or call 911. You can also go immediately to your local hospital emergency room. Please do not use email e-mail or faxes Faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office The counselor does not always check his e-mail or on vacation and may be unable to check her email or faxes Faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 90.00 per 45 minutes 50 minute session (individual), 150 per 60 for (individual) unless another type of payment option has been decided by the counselor or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; if you are using insurance or receiving services through an EAP. Self pay_ _ _ _ EAP Insurance provider Payment is expected at the end of each session unless otherwise agreed. There is a $6.00 charge for NSF checks. Other services available as an adjunct to counseling include flower essence consultations, coaching, groups, special service packages, and soulcollage. Payment for these services is outlined on my fee and service form and is specified above or at the end on a separate agreement form. If you are interested in any of the month unless other arrangements have been madethese services please ask for more information. Telephone conversations, site conversations of no more then 5 minutes between sessions are available at no charge unless there is an emergency - beyond that time you will be charged for session. Please see the Fee and Service sheet for pricing. Site visits, report writing and reading of reportsreading, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx if the counselor of any problems arise during the course of therapy regarding your ability to make timely payments. Clients who carry insurance should remember that at times professional services are rendered and may be charged directly to the clients and not to the insurance companies. Unless agreed upon differently, Xxxxxxxxx Xxxxx the counselor will provide you with a copy of your receipt on a monthly basisupon your request, which you can then submit to your insurance company for reimbursement, reimbursement if you so choose. As was indicated in the section, section Health Insurance & Confidentiality confidentiality of Recordsrecords, you must be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk. Not all issues/conditions/problems, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx the counselor can use legal or other means (courts, collection agencies, etc.) to obtain payment. THE PROCESS OF THERAPY/EVALUATION AND SCOPE OF PRACTICE: 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/counseling/coaching requires your very active involvement, honesty, and openness in order to change your thoughts, feelings and/or behavior. The counselor 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 you experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, etc, or experiencing anxiety, depression, insomnia, etc. The counselor may challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations, which 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 it may also be slow and even frustrating. There is no guarantee that psychotherapy will yield positive or intended results. During the course of therapy, the counselor is likely to draw on various psychological approaches according, in part, to the problem that is being treated and her assessment of what will best benefit you. These approaches include, but are not limited to, cognitive-behavioral, psychodynamic, solution focused, life coaching, mindfulness practices, existential, humanistic, psycho-educational and strength/empowerment based practices. The counselor provides neither custody evaluation recommendation nor medication or prescription recommendation nor legal advice, as these activities do not fall within her scope of practice.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx X. Xxxxxx, LCSW, CST, SEP between sessions, please leave a message at on the answering service (000-) 000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx X. Xxxxxx, LCSW, CST, SEP checks her his messages a few times during the daytime only, unless she he is out of town and will return your call within 24 hourstown. If an emergency situation arises, indicate it clearly in your message and if you are in need to talk to someone right away call a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may call 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 hour crisis line or 000-000-0000, or go immediately to your local hospital emergency roomthe Police: 911. Please do not use email e-mail, text or faxes Faxes for emergencies. Xxxxxxxxx Xxxxx may be with a clientX. Xxxxxx, out of the office LCSW, CST, SEP does not always check his e-mail, text or on vacation and may be unable to check her email or faxes Faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 100.00 per 45 minutes (individual), 150 per 60 for (individual) 50 minute session or $150.00 100.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; 50 minute session at the end of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, report writing and reading of reportsreading, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx X. Xxxxxx, LCSW, CST, SEP if any problems arise 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, Xxxxxxxxx Xxxxx X. Xxxxxx, LCSW, CST, SEP will provide you with a copy of your receipt on a monthly basis, which you can then submit to your insurance company for reimbursement, reimbursement if you so choose. As was indicated in the section, section Health Insurance & Confidentiality confidentiality of Recordsrecords, you must be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk. Not all issues/issues/ conditions/problems, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx X. Xxxxxx, LCSW, CST, SEP can use legal or other means (courts, collection agencies, etc.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx Xx. Xxxxxxx between sessions, please leave a message at the answering service cell number (000-) 000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx Xx. Xxxxxxx checks his/her messages a few times during the daytime only, unless she s/he is out of town and will return your call within 24 hourstown. If an emergency situation arises, indicate it clearly in your message and if you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may call 911, or 24-Hour need to talk to someone right away call: Multnomah County Mental Health Crisis Hotlines – National 1-800-273-TALK Line: (8255000) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, Suicide Prevention: (800) 273-TALK, or go immediately to your local hospital emergency roomthe Police: 911. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to Xx. Xxxxxxx does not always check his/her email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 240.00 per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; 55 minute session at the end of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx Xx. Xxxxxxx if any problems arise 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, Xxxxxxxxx Xxxxx Xx. Xxxxxxx’x billing service will submit a claim to your insurance company on your behalf. Xx. Xxxxxxx will provide you with a copy receipt of your receipt on a monthly basis, which any payment that you can then submit to your insurance company for reimbursement, if you so choosemake in the office. As was indicated in the section, Health Insurance & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx Xx. Xxxxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Dr. Xxxx Xxxxx between sessions, for non-emergency related matters, please leave a message at the answering service on her telephone (000-) 000-0000 and your call will be returned 0000. Xx. Xxxxx returns calls as soon as possible. Xxxxxxxxx Xxxxx checks her messages a few times during the daytime only, always within one business day, unless she is out of town and away from the office. Clients are notified in advance when Xx. Xxxxx will return your call within 24 hoursbe away. If an you are having a psychiatric emergency situation and need law enforcement support call the Police at 911 and ask for a Crisis Intervention Team (CIT) officer. CIT officers have been trained to deal with mental health crises. If you are in a crisis situationpsychiatric emergency, and Xxxxxxxxx Xxxxx canbut do not be reachedneed law enforcement support, you may can call 911, or 24-Hour the Ventura County Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000Team at 0-(000)-000-0000, or go immediately to . They will assess your local hospital emergency roomneeds over the phone and respond accordingly. Please do not use email or faxes for emergencies. Xxxxxxxxx Dr. Xxxx Xxxxx may be with a client, out of the office or on vacation and may be is often unable to check her email or faxes dailyfor many hours at a time. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 175.00 per 45 minutes (individual)55 minute, 150 per 60 for (individual) or $150.00 215.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; 75 minute session at the end conclusion of each session or at the end of the month unless other arrangements have been madeappointment. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwiserate of $175.00 per hour. Please notify Xxxxxxxxx Dr. Xxxx Xxxxx if any problems arise 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, Xxxxxxxxx Dr. Xxxx 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 & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Dr. Xxxx Xxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment. THE PROCESS OF THERAPY/EVALUATION AND SCOPE OF PRACTICE: 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 for you or your minor children. Working toward these benefits, however, requires effort on your and your young person’s part. Psychotherapy requires clients’ active involvement, honesty, and openness in order to change their thoughts, feelings, and behavior. Dr. Xxxx Xxxxx 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 you experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, etc., or experiencing anxiety, depression, insomnia, etc. Dr. Xxxx Xxxxx may challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations, which 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, other times it will be slow and even frustrating. There is no guarantee that psychotherapy will yield positive or intended results. During the course of therapy, Dr. Xxxx Xxxxx is likely to draw on various psychological approaches according, in part, to the problem that is being treated and her assessment of what will best benefit you and/or your young person. These approaches include, but are not limited to, behavioral, cognitive-behavioral, parent child interaction therapy, cognitive, psychodynamic, existential, system/family, developmental (adult, child, family), humanistic or psycho-educational. Dr. Xxxx Xxxxx provides neither custody evaluation recommendation nor medication or prescription recommendation nor legal advice, as these activities do not fall within her scope of practice.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xx. Xxxxxxx Xxxxxx-Xxxxx between sessions, please leave a message at the answering service contact his cell phone (000-) 000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xx. Xxxxxxx Xxxxxx-Xxxxx checks her his messages a few times during the daytime only, unless she he is out of town and will return your call within 24 hourstown. If an emergency situation arises, indicate it clearly in your message and if you are in a need to talk to someone right away, call Psychiatric Emergency Services, the 24-hour crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may call 911line, or 24-Hour Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, or go immediately to your local hospital emergency room911. Please do not use email or faxes for emergencies. Xxxxxxxxx Xx. Xxxxxxx Xxxxxx-Xxxxx may be with a client, out of the office or on vacation and may be unable to does not always check her his email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 per 45 minutes 250.00 for the initial therapeutic assessment session (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (coupleapproximately 60-75 minutes) and 175 $225.00 per 45-60 minutes (couple and family) session; minute session at the end beginning of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xx. Xxxxxxx Xxxxxx-Xxxxx if any problems arise 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, Xxxxxxxxx Xx. Xxxxxxx Xxxxxx-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 & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xx. Xxxxxxx Xxxxxx-Xxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment. THE PROCESS OF THERAPY/EVALUATION AND SCOPE OF PRACTICE: 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. Xx. Xxxxxxx Xxxxxx-Xxxxx 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 you experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, etc., or experiencing anxiety, depression, insomnia, etc. Xx. Xxxxxxx Xxxxxx-Xxxxx may challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations, which 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, Xx. Xxxxxxx Xxxxxx-Xxxxx is likely to draw on various psychological approaches according, in part, to the problem that is being treated and his assessment of what will best benefit you. These approaches include, but are not limited to, behavioral, cognitive-behavioral, cognitive, psychodynamic, existential, system/family, developmental (adult, child, family), humanistic or psycho-educational. Xx. Xxxxxxx Xxxxxx-Xxxxx provides neither custody evaluation recommendation nor medication or prescription recommendation nor legal advice, as these activities do not fall within his scope of practice.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx Xxxxxx Xxxxxxx between sessions, please leave a message at the answering service (000-) 000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx She checks her messages a few times a day (but never during the daytime onlynight time), unless she is out of town town. She checks the messages less frequently on weekends and will return your call within 24 hoursholidays. If an emergency situation and arises, please indicate it clearly in your message. If you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reachedneed to talk to someone right away, you may can call 911, or the 24-Hour Crisis Hotlines – National 1-800-273-TALK hour crisis line (8255000) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000the Police at: 9-0001-0000, or go immediately to your local hospital emergency room. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to check her email or faxes daily1. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee the standard Fee of $200 165 per 60 minute session or $185 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; at the end beginning of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, report writing and reading of reportsreading, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx your therapist if any problems arise 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, Xxxxxxxxx Xxxxx your therapist will provide you with a copy of your receipt on a monthly basis, which you can then submit to your insurance company for reimbursement, reimbursement if you so choose. As was indicated in the section, Health Insurance & 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/problemsproblem, which are dealt with in the focus of psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If THE PROCESS OF THERAPY/EVALUATION: Participation in therapy can result in a number of benefits to you, including improving interpersonal relationship and resolution of the specific concerns that led you to seek therapy. Working toward these benefits; however, requires effort on your account part. Psychotherapy requires a very active involvement, honesty, and openness in order to change your thoughts, feelings and/or behavior. Your therapist 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, etc. or experiencing depression, insomnia, etc. Your therapist 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, employments, substance use, schooling, housing, or relationships. Sometimes a decision that is overdue (unpaid) positive for one family member is viewed quite negatively by another family member. Change will sometimes be easy and there swift, but more often it will be slow and even frustrating. There is no written agreement guarantee that psychotherapy will yield positive or intended results. During the course of therapy, your therapist is likely to draw on various psychological approaches according, in part, to the problem that is being treated and her assessment of what will best benefit you. These approaches include behavioral, cognitive-behavioral, psychodynamics, somatic, transpersonal, system/family, psycho-educational, and eco-therapy. Discussion of Treatment Plan: Within a payment reasonable period of time after the initiation of treatment, your therapist will discuss with you (client) her working understanding of the problem, treatment plan, Xxxxxxxxx Xxxxx can use legal therapeutic objectives, and her view of the possible outcomes of treatment. IF you have any unanswered questions about any of the procedures to be used in the course of therapy, their possible risks, your therapist’s expertise in employing them, or about the treatment plan, please and you will be answered fully. You also have the right to ask about other means (courtstreatments for your condition and their risks and benefits. If you could benefit from any treatment that your therapist does not provide, collection agencies, etcshe has an ethical obligation to assist you obtaining those treatments.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xx. Xxxxxxxxx Xxxxx between sessions, please leave a message at the answering service on her voicemail (000-) 000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx checks her messages a few times during the daytime only, unless she is out of town and will return your call within 24 hours. If an emergency situation and you are in leaving a crisis situationmessage on the same day as your appointment, and Xxxxxxxxx Xxxxx cannot be reached, you may please call 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or my cell phone at 000-000-0000. If an emergency/crisis situation arises, please indicate it clearly in your message and proceed to contact assistance right away, such as the nearest hospital, the Police (911), your psychiatrist or go immediately to your local hospital emergency roomprimary care physician, a close friend or family member. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with also leave a client, out of the office or message on vacation and may be unable to check her email or faxes dailymy emergency cell phone at 818-674- 2502. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients You are expected to pay the standard fee of $120.00 450 for a 90 minute initial assessment and $225.00 per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; each 50 minute session at the end of each session or at the end of the month unless other arrangements have been made. Telephone conversationsShould the session be extended, as agreed by Xx. Xxxxxxxxx and you, a charge of $40.00 for each 10 minute increment (beyond the initial 50 minute session), or any fraction thereof, will be added. Only cash or personal checks are accepted. A service charge of $35.00 will be assessed for all returned checks. Client telephone conversations beyond 10 minutes, as well as client authorized site visits, report writing and reading of reportsreview, consultation with other professionals, release of information, reading records, longer sessions, and travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xx. Xxxxxxxxx Xxxxx if any problems arise 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 companiescompany. Unless agreed upon differently, Xx. Xxxxxxxxx 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, reimbursement if you so choose. As was indicated in the section, section “Health Insurance & Confidentiality of Of Records”, you must be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk. Not Additionally, not all issues/conditions/problems, which are dealt with in the focus of psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx me between sessionssessions with an emergency, please text me (preferred) or leave a message at the answering service (000-000-0000 with my voice mail and your call message will be returned as soon as possible. Xxxxxxxxx Xxxxx checks her I do my best to check my messages frequently, however, as I am not always available, please contact the crisis hotline or 911 in the case of a few times during the daytime only, unless she is out of town and will return your call within 24 hourscrisis or emergency. If an emergency situation and you are in a crisis situationneed to gain immediate assistance, and Xxxxxxxxx Xxxxx cannot be reached, you may please call 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK (8255) . The National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0Lifeline can be contacted at 1-000800- 273-000-0000 or 000-000-0000, or go immediately to your local hospital emergency room8255. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to check her email or faxes daily. PAYMENTS Payments & INSURANCE REIMBURSEMENTInsurance Reimbursement: Clients are expected to pay at initial appointment an intake assessment the agreed-upon fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; at the end of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site Site visits, writing and reading of reportsreport writing, in-person consultation (as requested by you) with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx me if any problems arise problem arises during the course of therapy regarding your ability to make timely payments. Clients For any last-minute cancellations (less than 24 hours’ notice) or no-show appointments, you are responsible for the full payment. Please know that you are always encouraged to explore other possibly more affordable services with your carrier such as through a Preferred Provider Option (PPO) or by seeing a clinician 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, Xxxxxxxxx Xxxxx will provide you is contracted with a copy of your receipt on a monthly basis, which you can then submit to your insurance company for reimbursementcompany. Mediation & Arbitration All disputes arising out of or in relation to this agreement to provide psychotherapy services shall first be referred to mediation, before, and as a pre-condition of, the initiation of arbitration. The mediator shall be a neutral third party chosen by agreement between us. The cost of such mediation, if you so chooseany, shall be split equally, unless otherwise agreed. As was indicated In the event that mediation is unsuccessful, any unresolved controversy related to this agreement should be submitted to and settled by binding arbitration in Yolo County, CA 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 section, Health Insurance & Confidentiality of Records, you must be aware event that submitting a mental health invoice for reimbursement carries a certain amount of risk. Not all issues/conditions/problems, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written foreseeable potential agreement on a payment plan, Xxxxxxxxx Xxxxx can I may use legal or other means (courtscourt, collection agenciesagency, 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 arbitrator will determine that sum. I will make every effort beforehand, however, to work with you to find a supportive, mutually-respectful arrangement for payment well before arbitration services are employed. 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 or your child’s/teen’s part. Psychotherapy requires your very active involvement, honesty, and openness in order to change your thoughts, feelings and/or behavior. I will ask for your feedback and views on our work together, its progress, and other aspects of the therapy and will encourage you to respond openly and honestly. During the course of therapy, I am likely to draw on various psychological approaches to address the problem that is being treated and my assessment of what will best benefit you. These approaches may include those from the psychodynamic, cognitive-behavioral, system/family, developmental (adult, child, family), or psycho-educational perspectives. Sometimes more than one approach can be helpful in dealing with a certain situation. Attempting to resolve issues that brought you to therapy in the first place may result in changes that were not originally intended. For example, during the initial phase of the evaluation or throughout the course of ongoing therapy, the process of reflecting on or talking about unpleasant events, feelings, or thoughts could elicit considerable discomfort including feelings of anger, sadness, worry, fear, anxiety, depression, etc. Additionally, as I challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations, this could potentially cause you to feel upset, saddened, anxious and/or disappointed. Psychotherapy may also affect your decision-making process and result in the changing of behaviors, employment, substance use, schooling, housing, or relationships. Sometimes a decision that is positive for one family member is viewed negatively by another family member. Change will sometimes be easy and swift, but more often, it will be slow and at times even frustrating. Lastly, it’s important to remember that there is no absolute guarantee that psychotherapy will yield positive or intended results. Please know, however, that I will do my very best to try to make our work together a meaningful and transformative experience for you. Your appointment will last 50 minutes. If I am providing services to your young child, please do not drop the client off in the waiting room without checking in with me first. I ask that you please be prompt in picking up your child after the appointment as I often have sessions scheduled each hour and would not want to risk leaving your child in the lobby unsupervised, unless specific arrangements are made in advance with you. I routinely offer clients a lollipop and cup of tea or hot chocolate at the beginning of sessions. If you or your child/teen has any dietary restrictions concerning any of these items, please let me know. By signing this form, you are agreeing to not hold me legally responsible for any incidental liquid xxxxx, unanticipated allergic reactions and/or related incidents of safety concern that may result from the consumption of these items.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx Xxxxxxx Xxxxxxxx between sessions, please leave a message at the answering service (000-) 000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx Xxxxxxx Xxxxxxxx checks her messages a few times during the daytime only, unless she is out of town and will return your call within 24 hourstown. If an emergency situation arises, indicate it clearly in your message and if you are in a crisis situationneed to talk to someone right away call Psychiatric Emergency Services: (000) 000-0000, and Xxxxxxxxx Xxxxx cannot be reached, you may call 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK hour crisis line: (8255000) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, or go immediately to your local hospital emergency roomthe Police: 911. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to Xxxxxxx Xxxxxxxx does not always check her email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 120 per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; 50-55 minute session at the end of each session or at the end of the month unless other arrangements have been mademade (Applies to cash pay clients). Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx Xxxxxxx Xxxxxxxx if any problems arise 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, Xxxxxxxxx Xxxxx Xxxxxxx Xxxxxxxx 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 & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx Xxxxxxx Xxxxxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment. THE PROCESS OF THERAPY/EVALUATION AND SCOPE OF PRACTICE: Participation in therapy can result in several 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. Xxxxxxx Xxxxxxxx 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 you experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, etc., or experiencing anxiety, depression, insomnia, etc. Xxxxxxx Xxxxxxxx may challenge some of your assumptions or perceptions or propose several ways of looking at, thinking about, or handling situations, which 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, Xxxxxxx Xxxxxxxx is likely to draw on various psychological approaches according, in part, to the problem that is being treated and her assessment of what will best benefit you. These approaches include, but are not limited to, behavioral, cognitive-behavioral, cognitive, psychodynamic, existential, system/family, developmental (adult, child, family), humanistic or psycho-educational. Xxxxxxx Xxxxxxxx provides neither custody evaluation recommendation nor medication or prescription recommendation nor legal advice, as these activities do not fall within her scope of practice.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx Xx. Xxxx Xxxxxx between sessions, please leave a message at on the answering service (000machine 310-000-0000 838- 6363 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx Xx. Xxxx Xxxxxx checks her messages a few times during the daytime only, unless she is out of town and will return your call within 24 hourstown. If an emergency situation arises, indicate it clearly in your message and if you are in a crisis situationneed to talk to someone right away call Psychiatric Emergency Services-Xxxx Xxxxx Community Mental Health Center, and Xxxxxxxxx Xxxxx cannot be reached, you may call 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, 0000 Xxxxxxxxx Xxxx.; or go immediately to your local hospital emergency room24-hour crisis line 000-000-0000; or the Police: 911. Please do not use email or faxes for emergenciesemergencies Xx. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to Xxxx Xxxxxx does not always check her email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 175.00 per 45 53+ minutes (individual), 150 per 60 for (individual) or $150.00 260.00 per 45 90 minutes for (couple) and 175 per 60 minutes (couple and family) session; at the end start of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx Xx. Xxxx Xxxxxx if any problems arise 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, Xxxxxxxxx Xxxxx Xx. Xxxx Xxxxxx 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 & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx Xx. Xxxx Xxxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment. Xx. Xxxx Xxxxxx from time to time increases the charge for a session in keeping with the increased cost of living. Should she do this, you will be notified a month in advance, so that you may make an informed choice as to whether you want to continue at the increased rate. MEDIATION & ARBITRATION: All disputes arising out of, or in relation to, this agreement to provide psychotherapy services shall first be referred to mediation, before, and as a pre-condition of, the initiation of arbitration. The mediator shall be a neutral third party chosen by agreement of Xx. Xxxx Xxxxxx and the client(s). The cost of such mediation, if any, shall be split equally, unless otherwise agreed upon. In the event that mediation is unsuccessful, any unresolved controversy related to this agreement should be submitted to and settled by binding arbitration in Los Angeles County, California in accordance with the rules of the American Arbitration Association which 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. Xxxx Xxxxxx 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 as and for attorney's fees. In the case of arbitration, the arbitrator will determine that sum. THE PROCESS OF THERAPY/EVALUATION AND SCOPE OF PRACTICE: 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.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx the therapist between sessions, please leave a voicemail message at the answering service (000-000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx The therapist checks his/her messages a few times during the daytime only, unless she s/he is out of town and will return your call within 24 hourstown. If an emergency situation arises, indicate it clearly in your message and if you are in a need to talk to someone right away call Psychiatric Emergency Services, 24-­‐hour crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may call line or the Police: 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, or go immediately to your local hospital emergency room. Please do not use email email, text messages or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to The therapist does not always check his/her email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment the agreed upon fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; at the end beginning of each session or at the end of the month unless other arrangements have been madesession. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx the therapist if any problems arise 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, Xxxxxxxxx Xxxxx the therapist 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 & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx the therapist can use legal or other means (courts, collection agencies, etc.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx between sessions, please leave a message or text at the answering service (000-000000)000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx checks her his messages a few times during the daytime only, unless she he is out of town and will return your call within 24 hourstown. If an emergency situation arises, indicate it clearly in your message and if you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, need to talk to someone right away you may choose to call 911, or 24-Hour the Yavapai Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-Line at 000-000-0000 or 000-000-0000, or go immediately to your local hospital emergency roomthe Police: 911. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to does not always check her his email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENTPAYMENTS: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 per 45 minutes (individual), 150 125 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; minute at the end of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx if any problems arise during the course of therapy your sessions 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, Xxxxxxxxx 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 & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx Xxxxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment. THE PROCESS OF IFS AND SCOPE OF PRACTICE: Participation in IFS can result in a number of benefits to you, including improving interpersonal relationships and resolution of the specific concerns that led you to seek help. Working toward these benefits, however, requires effort on your part. For IFS to be successful, it is required that you have a very active involvement during sessions, which includes honesty, and openness in order to change your thoughts, feelings, and/or behavior. Xxxxx will ask for your feedback and views on your session work, its progress, and other aspects of the work and will expect you to respond openly and honestly. Sometimes more than one approach can be helpful in dealing with a certain situation. During your sessions, remembering or talking about unpleasant events, feelings, or thoughts can result in you experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, etc., or experiencing anxiety, depression, insomnia, etc. Xxxxx xxx challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations, which can cause you to feel very upset, angry, depressed, challenged, or disappointed. Attempting to resolve issues that brought you to Xxxxx in the first place, such as personal or interpersonal relationships, may result in changes that were not originally intended. IFS sessions 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 IFS will yield positive or intended results. During the IFS xxxxxxxx, Xxxxx is likely to draw on various approaches according, in part, to the problem that is being addressed and his assessment of what will best benefit you. These approaches include, but are not limited to, Internal Family Systems and/or Energy Medicine. Xxxxx is not a psychotherapist. Xxxxx is a Certified Internal Family Systems Practitioner and has been professionally certified through the IFS Institute. Xxxxx provides neither custody evaluation recommendation nor medication or prescription recommendation nor legal advice, as these activities do not fall within his scope of practice. ENERGY MEDICINE Xxxxx xxx also incorporate a non-sexual form of touch known as Energy Medicine, as part of the sessions. Sexual touch of clients by practitioners is unethical and illegal. Xxxxx will ask your permission before touching you and you have the right to decline or refuse to be touched without any fear or concern of a negative response or reaction from your practitioner. The touch will be limited to areas of the upper back, shoulders, neck, face, head, and arms. Touch can be very beneficial but can also unexpectedly evoke emotions, thoughts, physical reactions, or memories that may be upsetting, depressing, evoke anger, etc. Sharing and processing such feelings with the practitioner, if they arise, may be a helpful part of your sessions. You may request not to be touched at any time during sessions without needing to explain it, if you choose not to, and without fear of a negative response or reaction from your practitioner.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx Xx. Xxxxxxx between sessions, please leave a message at the answering service (000-000000)000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx Xx. Xxxxxxx checks her messages a few times during the daytime only, unless she is out of town and will return your call within 24 hourstown. If an emergency situation arises, indicate it clearly in your message and if you are in a crisis situationneed to talk to someone right away call Psychiatric Emergency Services. (Santa Xxxxx County): (000) 000-0000, and Xxxxxxxxx Xxxxx cannot be reached, you may call 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK hour suicide crisis line (8255Santa Xxxxx County): 0 (000) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, or go immediately to your local hospital emergency roomthe Police: 911. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to Xx. Xxxxxxx does not always check her email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 175.00 per 45 50 minutes (individual), 150 per 60 for (individual) individual therapy or $150.00 200 per 45 50 minutes for (of couple) and 175 per 60 minutes (couple and family) session; at the end of each session or ’s therapy at the end of the month session, unless other arrangements have been made. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx Xx. Xxxxxxx promptly if any problems arise 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, Xxxxxxxxx Xxxxx Xx. Xxxxxxx 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 & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx Xx. Xxxxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx Xxxxxxx Xxxxxxxx between sessions, please leave a message at the answering service (000-) 000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx Xxxxxxx Xxxxxxxx checks her messages a few times during the daytime only, unless she is out of town and will return your call within 24 hourstown. If an emergency situation arises, indicate it clearly in your message and if you are in a crisis situationneed to talk to someone right away call Psychiatric Emergency Services: (000) 000-0000, and Xxxxxxxxx Xxxxx cannot be reached, you may call 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK hour crisis line: (8255000) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, or go immediately to your local hospital emergency roomthe Police: 911. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to Xxxxxxx Xxxxxxxx does not always check her email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 125 set per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; 50-55 minute session at the end beginning of each session or at the end of the month unless other arrangements have been made. This applies to cash paying clients. If it has been agreed upon, therapist will bill your insurance for payment, but final responsibility falls on the client to ensure payment. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx Xxxxxxx Xxxxxxxx if any problems arise 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, Xxxxxxxxx Xxxxx Xxxxxxx Xxxxxxxx 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 & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx Xxxxxxx Xxxxxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment. Xxxxxxx Xxxxxxxx does not backbill, meaning it is your responsibility to determine your insurance coverage and to notify her of these changes. If you are a cash paying client and you obtain new insurance and Xxxxxxx Xxxxxxxx is unaware of your new insurance and she is on your new panel, backbilling will not take place. Therefore, it is important to let her know as soon as possible of this change, so that your insurance could be adequately billed, and you receive the full benefits of using your insurance. THE PROCESS OF THERAPY/EVALUATION AND SCOPE OF PRACTICE: 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. Xxxxxxx Xxxxxxxx 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 you experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, etc., or experiencing anxiety, depression, insomnia, etc. Xxxxxxx Xxxxxxxx may challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations, which 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, Xxxxxxx Xxxxxxxx is likely to draw on various psychological approaches according, in part, to the problem that is being treated and her assessment of what will best benefit you. These approaches include, but are not limited to, behavioral, cognitive-behavioral, cognitive, psychodynamic, existential, system/family, developmental (adult, child, family), humanistic or psycho-educational. Xxxxxxx Xxxxxxxx provides neither custody evaluation recommendation nor medication or prescription recommendation nor legal advice, as these activities do not fall within her scope of practice.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx Xxxxxx Xxxxxx, LICSW dba Healing Matters Counseling between sessions, please leave a message at the answering service (000-) 000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx Xxxxxx Xxxxxx checks her messages a few times during the daytime only, unless she is out of town and will return your call within 24 hourstown. If an emergency situation arises, indicate it clearly in your message and if you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may need to talk to someone right away call 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, 911 or go immediately to your local hospital emergency room. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a clientXxxxxx Xxxxxx, out of the office or on vacation and may be unable to LICSW dba Healing Matters Counseling does not always check her email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 150.00- $180.00 per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; 55 minute session at the end beginning of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx Xxxxxx Xxxxxx, LICSW dba Healing Matters Counseling if any problems arise 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, Xxxxxxxxx Xxxxx will provide you with a A copy of your receipt on a monthly basis, which you can then submit to your insurance company for reimbursement, if you so chooseis available upon request. As was indicated in the section, Health Insurance & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx Xxxxxx Xxxxxx, LICSW dba Healing Matters Counseling can use legal or other means (courts, collection agencies, etc.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx Xxxxxxx Xxxxxxxxxx between sessions, please leave a message at the answering service (000-) 000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx Xxxxxxx Xxxxxxxxxx checks his/her messages a few times during the daytime only, unless she s/he is out of town and will return your call within 24 hourstown. If an emergency situation arises, indicate it clearly in your message and if you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may need to talk to someone right away call 911, or the 24-Hour Crisis Hotlines – National hour crisis line dialing 2-1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 1 or 000-000-0000, or go immediately to your local hospital emergency roomthe Police: 911. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to Xxxxxxx Xxxxxxxxxx does not always check her email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 125.00 per 45 45-50 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; at the end of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx Xxxxxxx Xxxxxxxxxx if any problems arise 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, Xxxxxxxxx Xxxxx Xxxxxxx Xxxxxxxxxx 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 & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx Xxxxxxx Xxxxxxxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx between sessions, please leave a message or text at the answering service (000-000000)000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx checks her messages a few times during the daytime only, unless she is out of town and will return your call within 24 hourstown. If an emergency situation arises, indicate it clearly in your message and if you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may need to talk to someone right away call 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-Psychiatric Emergency Services. Prescott: 000-000-0000 for 24-hour crisis line or 000-000-0000, or go immediately to your local hospital emergency roomthe Police: 911. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to does not always check her email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 100 per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; 50 minute at the end of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx if any problems arise 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, Xxxxxxxxx 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 & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx Xxxxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment. THE PROCESS OF THERAPY/EVALUATION AND SCOPE OF PRACTICE: 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. Xxxxx 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 you experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, etc., or experiencing anxiety, depression, insomnia, etc. Xxxxx xxx challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations, which 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, Xxxxx is likely to draw on various psychological approaches according, in part, to the problem that is being treated and her assessment of what will best benefit you. These approaches include, but are not limited to, behavioral, cognitive-behavioral, cognitive, psychodynamic, Somatic Experiencing, developmental (adult, child, family), Internal Family Systems or psycho-educational. Xxxxx provides neither custody evaluation recommendation nor medication or prescription recommendation nor legal advice, as these activities do not fall within her scope of practice.

TELEPHONE & EMERGENCY PROCEDURES. If you need to contact Xxxxxxxxx Xxxxx the practice between sessions, please leave a message at the answering service (000-) 000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx The practice checks her messages a few times during the daytime onlybusiness day, unless she the practice is out of town and will return your call within 24 hoursclosed. If an emergency situation arises, indicate it clearly in your message and if you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may need to talk to someone right away call 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK (8255) the National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa Lifeline 0-000-000-0000 or 000-000-0000, or go immediately to your local hospital emergency roomthe Police: 911. Please do not use email email, text messaging, or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to The practice does not always check her email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients The same fee rates will apply for telemental health as they apply for in-person psychotherapy. However, insurance or other managed care providers may not cover sessions that are expected to pay at initial appointment an intake assessment conducted via telecommunication. If your insurance, HMO, third-party payor, or other managed care provider does not cover electronic psychotherapy sessions, you will be solely responsible for the entire fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or familythe session. Please contact your insurance company prior to our engaging in telemental health sessions in order to determine whether these sessions will be covered. Clients are expected to pay the standard fee of $120.00 per 45 minutes (individual)145 for an intake and $85 for an individual session, 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) prior to each session; at the end of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx the practice if any problems arise 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, Xxxxxxxxx Xxxxx the practice 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 & 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, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx the practice can use legal or other means (courts, collection agencies, etc.) to obtain payment. THE PROCESS OF THERAPY/EVALUATION AND SCOPE OF PRACTICE: 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 practice 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 an evaluation or therapy, remembering or talking about unpleasant events, feelings, or thoughts can result in you experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, etc., or experiencing anxiety, depression, insomnia, etc. the practice may challenge some of your assumptions or perceptions or propose different ways of looking at, thinking about, or handling situations, which 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 practice is likely to draw on various psychological approaches according, in part, to the problem that is being treated and the assessment of what will best benefit you. These approaches include, but are not limited to, behavioral, cognitive-behavioral, cognitive, psychodynamic, person-centered, existential, system/family, developmental (adult, child, family), humanistic, or psycho-educational. The practice provides neither custody evaluation recommendation nor medication or prescription recommendation nor legal advice, as these activities do not fall within its scope of practice. TELEMENTAL HEALTH BENEFITS/RISKS: Telemental health refers to providing psychotherapy services remotely using telecommunications technologies, such as video conferencing or telephone. One of the benefits of telemental health is that the client and the practice can engage in services without being in the same physical location. This can be helpful in ensuring continuity of care if the client or the practice moves to a different location, takes an extended vacation, or is otherwise unable to continue to meet in person. It is also more convenient. Telemental health, however, requires technical competence for both the client and the practice in order to be helpful. Although there are benefits of telemental health, there are some differences between in-person psychotherapy and telemental health, as well as some risks. There are risks to confidentiality since telemental health sessions take place outside of the practice’s private office, there is potential for other people to overhear sessions if you are not in a private place during the session. The practice will take reasonable steps to ensure your privacy; however, it is important for you to make sure you find a private place for sessions where you will not be interrupted. It is also important for you to protect the privacy of sessions on your cell phone or other device. You should participate in therapy only while in a room or area where other people are not present and cannot overhear the conversation. There could possibly be issues related to technology, which may impact telemental health. For example, technology may stop working during a session, other people might be able to get access to private conversations between you and the practice, or stored data could be accessed by unauthorized people or companies. Since sessions take place remotely, there are limitations on how the practice can handle crisis situations. Therefore, usually, the practice will not engage in telemental health with clients, who are currently in a crisis situation requiring high levels of support and intervention. Before engaging in telemental health, we will develop an emergency response plan to address potential crisis situations that may arise during the course of our telemental health work. (See also relevant section above: “EMERGENCY”). Most research shows that telemental health is about as effective as in-person psychotherapy. However, some clinicians disagree with this. For example, there is debate about a clinician’s ability to fully understand non-verbal information when working remotely. Telemental health-based services may not yield the same results, nor be as complete as face-to-face services.