Common use of Your Expectations Clause in Contracts

Your Expectations. Be an active participant in therapy, share your ideas, thoughts, and feelings with your therapist, tell the truth, respect BRAINS by not damaging the building, furniture, or other objects, listen and talk in a respectful way to staff, and cooperate with person-centered clinical suggestions. Client Rights You have the right to... • Be treated with respect and compassion. • Receive care in a clean and smoke-free environment. • Collaborate in assessment & treatment planning, including implementation of strategies in home, school, and/or work environments to enhance your functioning. • Be free from mental, physical, sexual, and verbal abuse, neglect, and exploitation. • Have a family member or other representative participate in your treatment planning and care along with the right to restrict the sharing of information about your care. • Request treatment in any of BRAINS lines of service. However, your right to make decisions about your care does not mean that you can demand treatment or services that are inappropriate or unnecessary. Your primary clinician will discuss these options with you. • Review your records. Please ask a staff member to learn how to make a formal request for record review. • Understand financial consequences of your care. Insurance coverage and health plans are often confusing. BRAINS acts proactively to address insurance coverage issues, however, it is impossible for us to know the nuances of each policy, plan, or covered benefit. We will do our best to inform you of costs ahead of time and explain the outcome of insurance reimbursement as soon as the information is available to us. • Seek assistance from self-help or advocacy agencies. • File a formal written or verbal complaint with the Client Rights Advisor or one of the owners. There are Grievance Forms available in the main waiting room at BRAINS. One can also be mailed to you upon request. Filing a grievance will not result in retaliation or dismissal from services. If your concern is not resolved to your satisfaction, you also have the right to file a complaint with the following organization: The Better Business Client Responsibilities It is expected that… • You, your family, and visitors are responsible to treat BRAINS staff and facility with respect. • You are expected to use respectful language and communication, addressing staff in a calm manner. Should you choose to swear, raise your voice, threaten, or use intimidation toward staff, volunteers, or other clients/visitors, you will be asked to leave the premises. • BRAINS does not allow any illegal drugs or weapons on the premises. Should our office be made aware of the presence of such substances &/or weapons, you will be asked to leave &/or proper authorities will be contacted. BRAINS Staff do not use seclusion or restraint at any time. • BRAINS is a drug (illegal & legal-see restrictions below) & smoke-free facility. No smoking (tobacco, smokeless, etc.) is allowed in the building or within sight of the building. • Out of respect to other clients and professionals, please do not carry on extended cell-phone conversations in the waiting rooms. Please do not leave children unattended in the waiting room. Support staff will not act as child-care providers or take responsibility for entertaining children. • You are responsible for providing a complete and accurate history to your clinician. This should include prior assessments, treatment, interventions, and past & current medications. In this way, the clinician can best assess and develop appropriate treatment. If it is necessary for a client or family member/s to hold a legal-prescription medication while on-site, they are asked to keep the medication/s in original packaging & keep them secure while in the building. • You are responsible to inform your clinician/s if you are showing signs of a contagious illness. It will be determined how to proceed with scheduled treatment. • You are responsible to follow the suggestions and advice provided during the course of treatment. You may also discuss your concerns with your clinician. If your refusal of treatment prevents us from providing appropriate care according to ethical and professional standards, we may need to end our relationship with you after giving you reasonable notice. • You are responsible for providing information about any unexpected difficulties, changes in circumstances, or other factors which may complicate the treatment process. • You are responsible for maintaining your scheduled appointments. Reminder calls are a courtesy. Please do not rely on reminder calls as confirmation of your appointment due to possible technical errors. • You are responsible to inform us of any changes in your insurance coverage. You are responsible for meeting any financial obligations agreed to, and for providing us with correct information about sources of payment. Criteria for Discharge A client can be discharged from services consistent with the legal and ethical standards for the profession. Criteria can include but is not limited to the following: ongoing violation of rules, consistently not attending scheduled appointments, unpaid account balances, abusive Bureau, xxxxx://xxx.xxx.xxx, Michigan Department of Community behavior/ language towards staff or other clients, etc. Health, Bureau of Health Systems, (000)-000-0000. Children at BRAINS As parents/guardians, you have asked that BRAINS help teach your unnecessary. Your primary clinician will discuss these options with you. child to function at their highest potential. In order to do that, we need• Review records. Please ask a staff member to learn how to make a your help and promise to do our best to help your child and your family. We promise to: • Listen to what you say. • Listen to your ideas about goals and let you help decide what will happen in therapy. • Treat you with respect. • Be careful to honor your privacy unless we need to disclose something in order to protect your safety or the safety of others. Your expectations: • Be an active part of therapy. • Share your ideas, thoughts, and feelings with your therapist. • Tell the truth. • Respect BRAINS by not damaging the building, furniture, or other objects. • Talk in a respectful way to staff. • Listen to staff and cooperate with suggestions. Adults at BRAINS You have the right to: • Be treated with respect and compassion. • Receive care in a clean, smoke-free setting. • Collaborate in assessment & treatment planning, including implementation of strategies in home, school, and/or work environments to enhance your functioning. • Be free from mental, physical, sexual, and verbal abuse, neglect, and exploitation. • Have a family member or other representative participate in your treatment planning and care. You also have the right to restrict sharing of information about your care. • Request treatment in any of BRAINS lines of service. However, your right to make decisions about your care does not mean you can demand treatment or services that are inappropriate or formal request for record review. Fees may apply. • Understand financial consequences of your care. Insurance coverage and health plans are often confusing. BRAINS acts to address insurance coverage issues, however, it is impossible for us to know the nuances of each policy, plan, or covered benefit. We will do our best to inform you of costs prior to rendered services and explain the outcome of insurance reimbursement as soon as the information is available to us. • Seek assistance from self-help or advocacy agencies. Teens at BRAINS As parents/guardians, you have asked that BRAINS help teach your child to function at their highest potential. In order to do that, we need your help and promise to do our best to help your child and your family. We promise to: • Respect your ideas and feelings. • Listen to what you say. • Incorporate your ideas about goals and respect your input about the therapy process. • Treat you with respect. • Honor your privacy unless we need to disclose something in order to protect your safety or the safety of others. Your expectations: • Be an active part of therapy. • Share your ideas, thoughts, and feelings with your therapist. • Tell the truth. • Respect BRAINS by not damaging the building, furniture, or other objects. • Talk in a respectful way to staff. • Listen to staff and cooperate with suggestions.

Your Expectations. Be an active participant in therapy, share your ideas, thoughts, and feelings with your therapist, tell the truth, respect BRAINS by not damaging the building, furniture, or other objects, listen and talk in a respectful way to staff, and cooperate with person-centered clinical suggestions. Client Rights You have the right to... •  Be treated with respect and compassion. •  Receive care in a clean and smoke-free environment. •  Collaborate in assessment & treatment planning, including implementation of strategies in home, school, and/or work environments to enhance your functioning. •  Be free from mental, physical, sexual, and verbal abuse, neglect, and exploitation. •  Have a family member or other representative participate in your treatment planning and care along with the right to restrict the sharing of information about your care. •  Request treatment in any of BRAINS lines of service. However, your right to make decisions about your care does not mean that you can demand treatment or services that are inappropriate or unnecessary. Your primary clinician will discuss these options with you. •  Review your records. Please ask a staff member to learn how to make a formal request for record review. •  Understand financial consequences of your care. Insurance coverage and health plans are often confusing. BRAINS acts proactively to address insurance coverage issues, however, it is impossible for us to know the nuances of each policy, plan, or covered benefit. We will do our best to inform you of costs ahead of time and explain the outcome of insurance reimbursement as soon as the information is available to us. •  Seek assistance from self-help or advocacy agencies. •  File a formal written or verbal complaint with the Client Rights Advisor or one of the owners. There are Grievance Forms available in the main waiting room at BRAINS. One can also be mailed to you upon request. Filing a grievance will not result in retaliation or dismissal from services. If your concern is not resolved to your satisfaction, you also have the right to file a complaint with the following organization: The Better Business Client Responsibilities It is expected that… •  You, your family, and visitors are responsible to treat BRAINS staff and facility with respect. •  You are expected to use respectful language and communication, addressing staff in a calm manner. Should you choose to swear, raise your voice, threaten, or use intimidation toward staff, volunteers, or other clients/visitors, you will be asked to leave the premises. •  BRAINS does not allow any illegal drugs or weapons on the premises. Should our office be made aware of the presence of such substances &/or weapons, you will be asked to leave &/or proper authorities will be contacted. BRAINS Staff do not use seclusion or restraint at any time. •  BRAINS is a drug (illegal & legal-see restrictions below) & smoke-free facility. No smoking (tobacco, smokeless, etc.) is allowed in the building or within sight of the building. •  Out of respect to other clients and professionals, please do not carry on extended cell-phone conversations in the waiting rooms. Please do not leave children unattended in the waiting room. Support staff will not act as child-care providers or take responsibility for entertaining children. •  You are responsible for providing a complete and accurate history to your clinician. This should include prior assessments, treatment, interventions, and past & current medications. In this way, the clinician can best assess and develop appropriate treatment. If it is necessary for a client or family member/s to hold a legal-prescription medication while on-site, they are asked to keep the medication/s in original packaging & keep them secure while in the building. •  You are responsible to inform your clinician/s if you are showing signs of a contagious illness. It will be determined how to proceed with scheduled treatment. •  You are responsible to follow the suggestions and advice provided during the course of treatment. You may also discuss your concerns with your clinician. If your refusal of treatment prevents us from providing appropriate care according to ethical and professional standards, we may need to end our relationship with you after giving you reasonable notice. •  You are responsible for providing information about any unexpected difficulties, changes in circumstances, or other factors which may complicate the treatment process. •  You are responsible for maintaining your scheduled appointments. Reminder calls are a courtesy. Please do not rely on reminder calls as confirmation of your appointment due to possible technical errors. •  You are responsible to inform us of any changes in your insurance coverage. You are responsible for meeting any financial obligations agreed to, and for providing us with correct information about sources of payment. Criteria for Discharge A client can be discharged from services consistent with the legal and ethical standards for the profession. Criteria can include but is not limited to the following: ongoing violation of rules, consistently not attending scheduled appointments, unpaid account balances, abusive Bureau, xxxxx://xxx.xxx.xxx, Michigan Department of Community behavior/ language towards staff or other clients, etc. Health, Bureau of Health Systems, (000)-000-0000. Children at BRAINS As parents/guardians, you have asked that BRAINS help teach your unnecessary. Your primary clinician will discuss these options with you. child to function at their highest potential. In order to do that, we need• need  Review records. Please ask a staff member to learn how to make a your help and promise to do our best to help your child and your family. We promise to: •  Listen to what you say. •  Listen to your ideas about goals and let you help decide what will happen in therapy. •  Treat you with respect. •  Be careful to honor your privacy unless we need to disclose something in order to protect your safety or the safety of others. Your expectations: •  Be an active part of therapy. •  Share your ideas, thoughts, and feelings with your therapist. •  Tell the truth. •  Respect BRAINS by not damaging the building, furniture, or other objects. •  Talk in a respectful way to staff. •  Listen to staff and cooperate with suggestions. Adults at BRAINS You have the right to: •  Be treated with respect and compassion. •  Receive care in a clean, smoke-free setting. •  Collaborate in assessment & treatment planning, including implementation of strategies in home, school, and/or work environments to enhance your functioning. •  Be free from mental, physical, sexual, and verbal abuse, neglect, and exploitation. •  Have a family member or other representative participate in your treatment planning and care. You also have the right to restrict sharing of information about your care. •  Request treatment in any of BRAINS lines of service. However, your right to make decisions about your care does not mean you can demand treatment or services that are inappropriate or formal request for record review. Fees may apply. •  Understand financial consequences of your care. Insurance coverage and health plans are often confusing. BRAINS acts to address insurance coverage issues, however, it is impossible for us to know the nuances of each policy, plan, or covered benefit. We will do our best to inform you of costs prior to rendered services and explain the outcome of insurance reimbursement as soon as the information is available to us. •  Seek assistance from self-help or advocacy agencies. Teens at BRAINS As parents/guardians, you have asked that BRAINS help teach your child to function at their highest potential. In order to do that, we need your help and promise to do our best to help your child and your family. We promise to: •  Respect your ideas and feelings. •  Listen to what you say. •  Incorporate your ideas about goals and respect your input about the therapy process. •  Treat you with respect. •  Honor your privacy unless we need to disclose something in order to protect your safety or the safety of others. Your expectations: •  Be an active part of therapy. •  Share your ideas, thoughts, and feelings with your therapist. •  Tell the truth. •  Respect BRAINS by not damaging the building, furniture, or other objects. •  Talk in a respectful way to staff. •  Listen to staff and cooperate with suggestions.

Your Expectations. Be an active participant in therapy, share your ideas, thoughts, and feelings with your therapist, tell the truth, respect BRAINS by not damaging the building, furniture, or other objects, listen and talk in a respectful way to staff, and cooperate with person-centered clinical suggestions. Client Rights You have the right to... • Be treated with respect and compassion. • Receive care in a clean and smoke-free environment. • Collaborate in assessment & treatment planning, including implementation of strategies in home, school, and/or work environments to enhance your functioning. • Be free from mental, physical, sexual, and verbal abuse, neglect, and exploitation. • Have a family member or other representative participate in your treatment planning and care along with the right to restrict the sharing of information about your care. • Request treatment in any of BRAINS lines of service. However, your right to make decisions about your care does not mean that you can demand treatment or services that are inappropriate or unnecessary. Your primary clinician will discuss these options with you. • Review your records. Please ask a staff member to learn how to make a formal request for record review. • Understand financial consequences of your care. Insurance coverage and health plans are often confusing. BRAINS acts proactively to address insurance coverage issues, however, it is impossible for us to know the nuances of each policy, plan, or covered benefit. We will do our best to inform you of costs ahead of time and explain the outcome of insurance reimbursement as soon as the information is available to us. • Seek assistance from self-help or advocacy agencies. • File a formal written or verbal complaint with the Client Rights Advisor or one of the owners. There are Grievance Forms available in the main waiting room at BRAINS. One can also be mailed to you upon request. Filing a grievance will not result in retaliation or dismissal from services. If your concern is not resolved to your satisfaction, you also have the right to file a complaint with the following organization: The Better Business Bureau, xxxxx://xxx.xxx.xxx, Michigan Department of Community Health, Bureau of Health Systems, (000)-000-0000. Client Responsibilities It is expected that… • You, your family, and visitors are responsible to treat BRAINS staff and facility with respect. • You are expected to use respectful language and communication, addressing staff in a calm manner. Should you choose to swear, raise your voice, threaten, or use intimidation toward staff, volunteers, or other clients/visitors, you will be asked to leave the premises. • BRAINS does not allow any illegal drugs or weapons on the premises. Should our office be made aware of the presence of such substances &/or weapons, you will be asked to leave &/or proper authorities will be contacted. BRAINS Staff do not use seclusion or restraint at any time. • BRAINS is a drug (illegal & legal-see restrictions below) & smoke-free facility. No smoking (tobacco, smokeless, etc.) is allowed in the building or within sight of the building. • Out of respect to other clients and professionals, please do not carry on extended cell-phone conversations in the waiting rooms. Please do not leave children unattended in the waiting room. Support staff will not act as child-care providers or take responsibility for entertaining children. • You are responsible for providing a complete and accurate history to your clinician. This should include prior assessments, treatment, interventions, and past & current medications. In this way, the clinician can best assess and develop appropriate treatment. If it is necessary for a client or family member/s to hold a legal-prescription medication while on-site, they are asked to keep the medication/s in original packaging & keep them secure while in the building. • You are responsible to inform your clinician/s if you are showing signs of a contagious illness. It will be determined how to proceed with scheduled treatment. • You are responsible to follow the suggestions and advice provided during the course of treatment. You may also discuss your concerns with your clinician. If your refusal of treatment prevents us from providing appropriate care according to ethical and professional standards, we may need to end our relationship with you after giving you reasonable notice. • You are responsible for providing information about any unexpected difficulties, changes in circumstances, or other factors which may complicate the treatment process. • You are responsible for maintaining your scheduled appointments. Reminder calls are a courtesy. Please do not rely on reminder calls as confirmation of your appointment due to possible technical errors. • You are responsible to inform us of any changes in your insurance coverage. You are responsible for meeting any financial obligations agreed to, and for providing us with correct information about sources of payment. Criteria for Discharge A client can be discharged from services consistent with the legal and ethical standards for the profession. Criteria can include but is not limited to the following: ongoing violation of rules, consistently not attending scheduled appointments, unpaid account balances, abusive Bureau, xxxxx://xxx.xxx.xxx, Michigan Department of Community behavior/ language towards staff or other clients, etc. Health, Bureau of Health Systems, (000)-000-0000. Children at BRAINS As parents/guardians, you have asked that BRAINS help teach your can demand treatment or services that are inappropriate or unnecessary. Your primary clinician will discuss these options with you. • Review records. Please ask a staff member to learn how to make a formal request for record review. Fees may apply. child to function at their highest potential. In order to do that, we need• Review recordsUnderstand financial consequences of your care. Please ask a staff member to learn how to make a Insurance your help and promise to do our best to help your child and your family. We promise to: • Listen to what you say. • Listen to your ideas about goals and let you help decide what will happen in therapy. • Treat you with respect. • Be careful to honor your privacy unless we need to disclose something in order to protect your safety or the safety of others. Your expectations: • Be an active part of therapy. • Share your ideas, thoughts, and feelings with your therapist. • Tell the truth. • Respect BRAINS by not damaging the building, furniture, or other objects. • Talk in a respectful way to staff. • Listen to staff and cooperate with suggestions. Adults at BRAINS You have the right to: • Be treated with respect and compassion. • Receive care in a clean, smoke-free setting. • Collaborate in assessment & treatment planning, including implementation of strategies in home, school, and/or work environments to enhance your functioning. • Be free from mental, physical, sexual, and verbal abuse, neglect, and exploitation. • Have a family member or other representative participate in your treatment planning and care. You also have the right to restrict sharing of information about your care. • Request treatment in any of BRAINS lines of service. However, your right to make decisions about your care does not mean you can demand treatment or services that are inappropriate or formal request for record review. Fees may apply. • Understand financial consequences of your care. Insurance coverage and health plans are often confusing. BRAINS acts to address insurance coverage issues, however, it is impossible for us to know the nuances of each policy, plan, or covered benefit. We will do our best to inform you of costs prior to rendered services and explain the outcome of insurance reimbursement as soon as the information is available to us. • Seek assistance from self-help or advocacy agencies. Teens at BRAINS As parents/guardians, you have asked that BRAINS help teach your child to function at their highest potential. In order to do that, we need your help and promise to do our best to help your child and your family. We promise to: • Respect your ideas and feelings. • Listen to what you say. • Incorporate your ideas about goals and respect your input about the therapy process. • Treat you with respect. • Honor your privacy unless we need to disclose something in order to protect your safety or the safety of others. Your expectations: • Be an active part of therapy. • Share your ideas, thoughts, and feelings with your therapist. • Tell the truth. • Respect BRAINS by not damaging the building, furniture, or other objects. • Talk in a respectful way to staff. • Listen to staff and cooperate with suggestions.

Your Expectations. Be an active participant in therapy, share your ideas, thoughts, and feelings with your therapist, tell the truth, respect BRAINS by not damaging the building, furniture, or other objects, listen and talk in a respectful way to staff, and cooperate with person-centered clinical suggestions. Client Rights You have the right to... • Be treated with respect and compassion. • Receive care in a clean and smoke-free environment. • Collaborate in assessment & treatment planning, including implementation of strategies in home, school, and/or work environments to enhance your functioning. • Be free from mental, physical, sexual, and verbal abuse, neglect, and exploitation. • Have a family member or other representative participate in your treatment planning and care along with the right to restrict the sharing of information about your care. • Request treatment in any of BRAINS lines of service. However, your right to make decisions about your care does not mean that you can demand treatment or services that are inappropriate or unnecessary. Your primary clinician will discuss these options with you. • Review your records. Please ask a staff member to learn how to make a formal request for record review. • Understand financial consequences of your care. Insurance coverage and health plans are often confusing. BRAINS acts proactively to address insurance coverage issues, ; however, it is impossible for us to know the nuances of each policy, plan, or covered benefit. We will do our best to inform you of costs ahead of time and explain the outcome of insurance reimbursement as soon as the information is available to us. • Seek assistance from self-help or advocacy agencies. • File a formal written or verbal complaint with the Client Rights Advisor or one of the owners. There are Grievance Forms available in the main waiting room at BRAINS. One can also be mailed to you upon request. Filing a grievance will not result in retaliation or dismissal from services. If your concern is not resolved to your satisfaction, you also have the right to file a complaint with the following organization: The Better Business Bureau, xxxxx://xxx.xxx.xxx, Michigan Department of Community Health, Bureau of Health Systems, (000)-000-0000. Client Responsibilities It is expected that… • You, your family, and visitors are responsible to treat BRAINS staff and facility with respect. • You are expected to use respectful language and communication, addressing staff in a calm manner. Should you choose to swear, raise your voice, threaten, or use intimidation toward staff, volunteers, or other clients/visitors, you will be asked to leave the premises. • BRAINS does not allow any illegal drugs or weapons on the premises. Should our office be made aware of the presence of such substances &/or weapons, you will be asked to leave &/or proper authorities will be contacted. BRAINS Staff do not use seclusion or restraint at any time. • BRAINS is a drug (illegal & legal-see restrictions below) & smoke-free facility. No smoking (tobacco, smokeless, etc.) is allowed in the building or within sight of the building. • Out of respect to other clients and professionals, please do not carry on extended cell-phone conversations in the waiting rooms. Please do not leave children unattended in the waiting room. Support staff will not act as child-care providers or take responsibility for entertaining children. • You are responsible for providing a complete and accurate history to your clinician. This should include prior assessments, treatment, interventions, and past & current medications. In this way, the clinician can best assess and develop appropriate treatment. If it is necessary for a client or family member/s to hold a legal-prescription medication while on-site, they are asked to keep the medication/s in original packaging & keep them secure while in the building. • You are responsible to inform your clinician/s if you are showing signs of a contagious illness. It will be determined how to proceed with scheduled treatment. • You are responsible to follow the suggestions and advice provided during the course of treatment. You may also discuss your concerns with your clinician. If your refusal of treatment prevents us from providing appropriate care according to ethical and professional standards, we may need to end our relationship with you after giving you reasonable notice. • You are responsible for providing information about any unexpected difficulties, changes in circumstances, or other factors which may complicate the treatment process. • You are responsible for maintaining your scheduled appointments. Reminder calls are a courtesy. Please do not rely on reminder calls as confirmation of your appointment due to possible technical errors. • You are responsible to inform us of any changes in your insurance coverage. You are responsible for meeting any financial obligations agreed to, and for providing us with correct information about sources of payment. Criteria for Discharge A client can be discharged from services consistent with the legal and ethical standards for the profession. Criteria can include but is not limited to the following: ongoing violation of rules, consistently not attending scheduled appointments, unpaid account balances, abusive Bureau, xxxxx://xxx.xxx.xxx, Michigan Department of Community behavior/ language towards staff or other clients, etc. Health, Bureau of Health Systems, (000)-000-0000. Children at BRAINS As parents/guardians, you have asked that BRAINS help teach your can demand treatment or services that are inappropriate or unnecessary. Your primary clinician will discuss these options with you. • Review records. Please ask a staff member to learn how to make a formal request for record review. Fees may apply. child to function at their highest potential. In order to do that, we need• Review recordsneed • Understand financial consequences of your care. Please ask a staff member to learn how to make a Insurance your help and promise to do our best to help your child and your family. We promise to: • Listen to what you say. • Listen to your ideas about goals and let you help decide what will happen in therapy. • Treat you with respect. • Be careful to honor your privacy unless we need to disclose something in order to protect your safety or the safety of others. Your expectations: • Be an active part of therapy. • Share your ideas, thoughts, and feelings with your therapist. • Tell the truth. • Respect BRAINS by not damaging the building, furniture, or other objects. • Talk in a respectful way to staff. • Listen to staff and cooperate with suggestions. Adults at BRAINS You have the right to: • Be treated with respect and compassion. • Receive care in a clean, smoke-free setting. • Collaborate in assessment & treatment planning, including implementation of strategies in home, school, and/or work environments to enhance your functioning. • Be free from mental, physical, sexual, and verbal abuse, neglect, and exploitation. • Have a family member or other representative participate in your treatment planning and care. You also have the right to restrict sharing of information about your care. • Request treatment in any of BRAINS lines of service. However, your right to make decisions about your care does not mean you can demand treatment or services that are inappropriate or formal request for record review. Fees may apply. • Understand financial consequences of your care. Insurance coverage and health plans are often confusing. BRAINS acts to address insurance coverage issues, however, it is impossible for us to know the nuances of each policy, plan, or covered benefit. We will do our best to inform you of costs prior to rendered services and explain the outcome of insurance reimbursement as soon as the information is available to us. • Seek assistance from self-help or advocacy agencies. Teens at BRAINS As parents/guardians, you have asked that BRAINS help teach your child to function at their highest potential. In order to do that, we need your help and promise to do our best to help your child and your family. We promise to: • Respect your ideas and feelings. • Listen to what you say. • Incorporate your ideas about goals and respect your input about the therapy process. • Treat you with respect. • Honor your privacy unless we need to disclose something in order to protect your safety or the safety of others. Your expectations: • Be an active part of therapy. • Share your ideas, thoughts, and feelings with your therapist. • Tell the truth. • Respect BRAINS by not damaging the building, furniture, or other objects. • Talk in a respectful way to staff. • Listen to staff and cooperate with suggestions.

Your Expectations. Be an active participant in therapy, share your ideas, thoughts, and feelings with your therapist, tell the truth, respect BRAINS by not damaging the building, furniture, or other objects, listen and talk in a respectful way to staff, and cooperate with person-centered clinical suggestions. Client Rights You have the right to... • Be treated with respect and compassion. • Receive care in a clean and smoke-free environment. • Collaborate in assessment & treatment planning, including implementation of strategies in home, school, and/or work environments to enhance your functioning. • Be free from mental, physical, sexual, and verbal abuse, neglect, and exploitation. • Have a family member or other representative participate in your treatment planning and care along with the right to restrict the sharing of information about your care. • Request treatment in any of BRAINS lines of service. However, your right to make decisions about your care does not mean that you can demand treatment or services that are inappropriate or unnecessary. Your primary clinician will discuss these options with you. • Review your records. Please ask a staff member to learn how to make a formal request for record review. • Understand financial consequences of your care. Insurance coverage and health plans are often confusing. BRAINS acts proactively to address insurance coverage issues, however, it is impossible for us to know the nuances of each policy, plan, or covered benefit. We will do our best to inform you of costs ahead of time and explain the outcome of insurance reimbursement as soon as the information is available to us. • Seek assistance from self-help or advocacy agencies. • File a formal written or verbal complaint with the Client Rights Advisor or one of the owners. There are Grievance Forms available in the main waiting room at BRAINS. One can also be mailed to you upon request. Filing a grievance will not result in retaliation or dismissal from services. If your concern is not resolved to your satisfaction, you also have the right to file a complaint with the following organization: The Better Business Bureau xxxxx://xxx.xxx.xxx Michigan Department of Community Health Bureau of Health Systems 000-000-0000 Client Responsibilities It is expected that… • You, your family, and visitors are responsible to treat BRAINS staff and facility with respect. • You are expected to use respectful language and communication, addressing staff in a calm manner. Should you choose to swear, raise your voice, threaten, or use intimidation toward staff, volunteers, or other clients/visitors, you will be asked to leave the premises. • BRAINS does not allow any illegal drugs or weapons on the premises. Should our office be made aware of the presence of such substances &/or weapons, you will be asked to leave &/or proper authorities will be contacted. BRAINS Staff do not use seclusion or restraint at any time. • BRAINS is a drug (illegal & legal-see restrictions below) & smoke-free facility. No smoking (tobacco, smokeless, etc.) is allowed in the building or within sight of the building. • Out of respect to other clients and professionals, please do not carry on extended cell-phone conversations in the waiting rooms. Please do not leave children unattended in the waiting room. Support staff will not act as child-care providers or take responsibility for entertaining children. • You are responsible for providing a complete and accurate history to your clinician. This should include prior assessments, treatment, interventions, and past & current medications. In this way, the clinician can best assess and develop appropriate treatment. If it is necessary for a client or family member/s to hold a legal-prescription medication while on-site, they are asked to keep the medication/s in original packaging & keep them secure while in the building. • You are responsible to inform your clinician/s if you are showing signs of a contagious illness. It will be determined how to proceed with scheduled treatment. • You are responsible to follow the suggestions and advice provided during the course of treatment. You may also discuss your concerns with your clinician. If your refusal of treatment prevents us from providing appropriate care according to ethical and professional standards, we may need to end our relationship with you after giving you reasonable notice. • You are responsible for providing information about any unexpected difficulties, changes in circumstances, or other factors which may complicate the treatment process. • You are responsible for maintaining your scheduled appointments. Reminder calls are a courtesy. Please do not rely on reminder calls as confirmation of your appointment due to possible technical errors. • You are responsible to inform us of any changes in your insurance coverage. You are responsible for meeting any financial obligations agreed to, and for providing us with correct information about sources of payment. Criteria for Discharge A client can be discharged from services consistent with the legal and ethical standards for the profession. Criteria can include but is not limited to the following: ongoing violation of rules, consistently not attending scheduled appointments, unpaid account balances, abusive Bureau, xxxxx://xxx.xxx.xxx, Michigan Department of Community behavior/ language towards staff or other clients, etc. Health, Bureau of Health Systems, (000)-000-0000. Children at BRAINS As parents/guardians, you have asked that BRAINS help teach your unnecessary. Your primary clinician will discuss these options with you. child to function at their highest potential. In order to do that, we need• Review records. Please ask a staff member to learn how to make a need your help and promise to do our best to help your child and your family. We promise to: • Listen to what you say. • Listen to your ideas about goals and let you help decide what will happen in therapy. volunteers, or other clients/visitors, you will be asked to leave the • Treat you with respect. premises. • BRAINS does not allow any illegal drugs or weapons on the premises. Should our office be made aware of the presence of • Be careful to honor your privacy unless we need to disclose something in order to protect your safety or the safety of others. Your expectations: • Be an active part of therapy. • Share your ideas, thoughts, and feelings with your therapist. • Tell the truth. • Respect BRAINS by not damaging the building, furniture, or other objects. • Talk in a respectful way to staff. • Listen to staff and cooperate with suggestions. Adults at BRAINS You have the right to: • Be treated with respect and compassion. • Receive care in a clean, smoke-free setting. • Collaborate in assessment & treatment planning, including implementation of strategies in home, school, and/or work environments to enhance your functioning. • Be free from mental, physical, sexual, and verbal abuse, neglect, and exploitation. • Have a family member or other representative participate in your treatment planning and care. You also have the right to restrict sharing of information about your care. • Request treatment in any of BRAINS lines of service. However, your right to make decisions about your care does not mean you can demand treatment or services that are inappropriate or unnecessary. Your primary clinician will discuss these options with you. • Review records. Please ask a staff member to learn how to make a formal request for record review. Fees may apply. • Understand financial consequences of your care. Insurance coverage and health plans are often confusing. BRAINS acts to address insurance coverage issues, however, it is impossible for us to know the nuances of each policy, plan, or covered benefit. We will do our best to inform you of costs prior to rendered services and explain the outcome of insurance reimbursement as soon as the information is available to us. • Seek assistance from self-help or advocacy agencies. Teens at BRAINS As parents/guardians, you have asked that BRAINS help teach your child to function at their highest potential. In order to do that, we need your help and promise to do our best to help your child and your family. We promise to: • Respect your ideas and feelings. • Listen to what you say. • Incorporate your ideas about goals and respect your input about the therapy process. • Treat you with respect. • Honor your privacy unless we need to disclose something in order to protect your safety or the safety of others. Your expectations: • Be an active part of therapy. • Share your ideas, thoughts, and feelings with your therapist. • Tell the truth. • Respect BRAINS by not damaging the building, furniture, or other objects. • Talk in a respectful way to staff. • Listen to staff and cooperate with suggestions.. address insurance coverage issues, however, it is impossible for us

Your Expectations. Be an active participant in therapy, share your ideas, thoughts, and feelings with your therapist, tell the truth, respect BRAINS by not damaging the building, furniture, or other objects, listen and talk in a respectful way to staff, and cooperate with person-centered clinical suggestions. Client Rights You have the right to... • Be treated with respect and compassion. • Receive care in a clean and smoke-free environment. • Collaborate in assessment & treatment planning, including implementation of strategies in home, school, and/or work environments to enhance your functioning. • Be free from mental, physical, sexual, and verbal abuse, neglect, and exploitation. • Have a family member or other representative participate in your treatment planning and care along with the right to restrict the sharing of information about your care. • Request treatment in any of BRAINS lines of service. However, your right to make decisions about your care does not mean that you can demand treatment or services that are inappropriate or unnecessary. Your primary clinician will discuss these options with you. • Review your records. Please ask a staff member to learn how to make a formal request for record review. • Understand financial consequences of your care. Insurance coverage and health plans are often confusing. BRAINS acts proactively to address insurance coverage issues, ; however, it is impossible for us to know the nuances of each policy, plan, or covered benefit. We will do our best to inform you of costs ahead of time and explain the outcome of insurance reimbursement as soon as the information is available to us. • Seek assistance from self-help or advocacy agencies. • File a formal written or verbal complaint with the Client Rights Advisor or one of the owners. There are Grievance Forms available in the main waiting room at BRAINS. One can also be mailed to you upon request. Filing a grievance will not result in retaliation or dismissal from services. If your concern is not resolved to your satisfaction, you also have the right to file a complaint with the following organization: The Better Business Client Responsibilities It is expected that… • You, your family, and visitors are responsible to treat BRAINS staff and facility with respect. • You are expected to use respectful language and communication, addressing staff in a calm manner. Should you choose to swear, raise your voice, threaten, or use intimidation toward staff, volunteers, or other clients/visitors, you will be asked to leave the premises. • BRAINS does not allow any illegal drugs or weapons on the premises. Should our office be made aware of the presence of such substances &/or weapons, you will be asked to leave &/or proper authorities will be contacted. BRAINS Staff do not use seclusion or restraint at any time. • BRAINS is a drug (illegal & legal-see restrictions below) & smoke-free facility. No smoking (tobacco, smokeless, etc.) is allowed in the building or within sight of the building. • Out of respect to other clients and professionals, please do not carry on extended cell-phone conversations in the waiting rooms. Please do not leave children unattended in the waiting room. Support staff will not act as child-care providers or take responsibility for entertaining children. • You are responsible for providing a complete and accurate history to your clinician. This should include prior assessments, treatment, interventions, and past & current medications. In this way, the clinician can best assess and develop appropriate treatment. If it is necessary for a client or family member/s to hold a legal-prescription medication while on-site, they are asked to keep the medication/s in original packaging & keep them secure while in the building. • You are responsible to inform your clinician/s if you are showing signs of a contagious illness. It will be determined how to proceed with scheduled treatment. • You are responsible to follow the suggestions and advice provided during the course of treatment. You may also discuss your concerns with your clinician. If your refusal of treatment prevents us from providing appropriate care according to ethical and professional standards, we may need to end our relationship with you after giving you reasonable notice. • You are responsible for providing information about any unexpected difficulties, changes in circumstances, or other factors which may complicate the treatment process. • You are responsible for maintaining your scheduled appointments. Reminder calls are a courtesy. Please do not rely on reminder calls as confirmation of your appointment due to possible technical errors. • You are responsible to inform us of any changes in your insurance coverage. You are responsible for meeting any financial obligations agreed to, and for providing us with correct information about sources of payment. Criteria for Discharge A client can be discharged from services consistent with the legal and ethical standards for the profession. Criteria can include but is not limited to the following: ongoing violation of rules, consistently not attending scheduled appointments, unpaid account balances, abusive Bureau, xxxxx://xxx.xxx.xxx, Michigan Department of Community behavior/ language towards staff or other clients, etc. Health, Bureau of Health Systems, (000)-000-0000. Children at BRAINS As parents/guardians, you have asked that BRAINS help teach your unnecessary. Your primary clinician will discuss these options with you. child to function at their highest potential. In order to do that, we need• need • Review records. Please ask a staff member to learn how to make a your help and promise to do our best to help your child and your family. We promise to: • Listen to what you say. • Listen to your ideas about goals and let you help decide what will happen in therapy. • Treat you with respect. • Be careful to honor your privacy unless we need to disclose something in order to protect your safety or the safety of others. Your expectations: • Be an active part of therapy. • Share your ideas, thoughts, and feelings with your therapist. • Tell the truth. • Respect BRAINS by not damaging the building, furniture, or other objects. • Talk in a respectful way to staff. • Listen to staff and cooperate with suggestions. Adults at BRAINS You have the right to: • Be treated with respect and compassion. • Receive care in a clean, smoke-free setting. • Collaborate in assessment & treatment planning, including implementation of strategies in home, school, and/or work environments to enhance your functioning. • Be free from mental, physical, sexual, and verbal abuse, neglect, and exploitation. • Have a family member or other representative participate in your treatment planning and care. You also have the right to restrict sharing of information about your care. • Request treatment in any of BRAINS lines of service. However, your right to make decisions about your care does not mean you can demand treatment or services that are inappropriate or formal request for record review. Fees may apply. • Understand financial consequences of your care. Insurance coverage and health plans are often confusing. BRAINS acts to address insurance coverage issues, however, it is impossible for us to know the nuances of each policy, plan, or covered benefit. We will do our best to inform you of costs prior to rendered services and explain the outcome of insurance reimbursement as soon as the information is available to us. • Seek assistance from self-help or advocacy agencies. Teens at BRAINS As parents/guardians, you have asked that BRAINS help teach your child to function at their highest potential. In order to do that, we need your help and promise to do our best to help your child and your family. We promise to: • Respect your ideas and feelings. • Listen to what you say. • Incorporate your ideas about goals and respect your input about the therapy process. • Treat you with respect. • Honor your privacy unless we need to disclose something in order to protect your safety or the safety of others. Your expectations: • Be an active part of therapy. • Share your ideas, thoughts, and feelings with your therapist. • Tell the truth. • Respect BRAINS by not damaging the building, furniture, or other objects. • Talk in a respectful way to staff. • Listen to staff and cooperate with suggestions.

Your Expectations. Be an active participant in therapy, share your ideas, thoughts, and feelings with your therapist, tell the truth, respect BRAINS by not damaging the building, furniture, or other objects, listen and talk in a respectful way to staff, and cooperate with person-centered clinical suggestions. Client Rights You have the right to... • Be treated with respect and compassion. • Receive care in a clean and smoke-free environment. • Collaborate in assessment & treatment planning, including implementation of strategies in home, school, and/or work environments to enhance your functioning. • Be free from mental, physical, sexual, and verbal abuse, neglect, and exploitation. • Have a family member or other representative participate in your treatment planning and care along with the right to restrict the sharing of information about your care. • Request treatment in any of BRAINS lines of service. However, your right to make decisions about your care does not mean that you can demand treatment or services that are inappropriate or unnecessary. Your primary clinician will discuss these options with you. • Review your records. Please ask a staff member to learn how to make a formal request for record review. • Understand financial consequences of your care. Insurance coverage and health plans are often confusing. BRAINS acts proactively to address insurance coverage issues, however, it is impossible for us to know the nuances of each policy, plan, or covered benefitbenefits. We will do our best to inform you of costs ahead of time and explain the outcome of insurance reimbursement as soon as the information is available to us. • Seek assistance from self-help or advocacy agencies. agencies • File a formal written or verbal complaint with the Client Rights Advisor or one of the owners. There are Grievance Forms available in the main waiting room at BRAINS. One can also be mailed to you upon request. Filing a grievance will not result in retaliation or dismissal from services. If your concern is not resolved to your satisfaction, you also have the right to file a complaint with the following organization: The Better Business Bureau xxxxx://xxx.xxx.xxx Michigan Department of Community Health Bureau of Health Systems 000-000-0000 Client Responsibilities It is expected that… • You, your family, and visitors are responsible to treat BRAINS staff and facility with respect. • You are expected to use respectful language and communication, addressing staff in a calm manner. Should you choose to swear, raise your voice, threaten, or use intimidation toward staff, volunteers, or other clients/visitors, you will be asked to leave the premises. • BRAINS does not allow any illegal drugs or weapons on the premises. Should our office be made aware of the presence of such substances &/or weapons, weapons you will be asked to leave &/or proper authorities will be contacted. BRAINS Staff do not use seclusion or restraint at any time. • BRAINS is a drug (illegal & legal-see restrictions below) & smoke-free facility. No smoking (tobacco, smokeless, etc.) is allowed in the building or within sight of the building. • Out of respect to other clients and professionals, please do not carry on extended cell-phone conversations in the waiting rooms. Please do not leave children unattended in the waiting room. Support staff will not act as child-care providers or take responsibility for entertaining children. • You are responsible for providing a complete and accurate history to your clinician. This should include prior assessments, treatment, interventions, and past & current medications. In this way, the clinician can best assess and develop appropriate treatment. If it is necessary for a client or family member/s to hold a legal-legal- prescription medication while on-site, they are asked to keep the medication/s in original packaging & keep them secure while in the building. • You are responsible to inform your clinician/s if you are showing signs of a contagious illness. It will be determined how to proceed with scheduled treatment. • You are responsible to follow the suggestions and advice provided during the course of treatment. You may also discuss your concerns with your clinician. If your refusal of treatment prevents us from providing appropriate care according to ethical and professional standards, we may need to end our relationship with you after giving you reasonable notice. • You are responsible for providing information about any unexpected difficulties, changes in circumstances, or other factors which may complicate the treatment process. • You are responsible for maintaining your scheduled appointments. Reminder calls are a courtesy. Please do not rely on reminder calls as confirmation of your appointment due to possible technical errors. • You are responsible to inform us of any changes in your insurance coverage. You are responsible for meeting any financial obligations agreed to, to and for providing us with correct information about sources of payment. Criteria for Discharge A client can be discharged from services consistent with the legal and ethical standards for the profession. Criteria can include but is not limited to the following: ongoing violation of rules, consistently not attending scheduled appointments, unpaid account balances, abusive Bureau, xxxxx://xxx.xxx.xxx, Michigan Department of Community behavior/ language towards staff or other clients, etc. Health, Bureau of Health Systems, (000)-000-0000. etc Children at BRAINS As parents/guardians, you have asked that BRAINS help teach your unnecessary. Your primary clinician will discuss these options with you. child to function at their highest potential. In order to do that, we need• Review records. Please ask a staff member to learn how to make a need your help and promise to do our best to help your child and your family. We promise to: • ▪ Listen to what you say. • say ▪ Listen to your ideas about goals and let you help decide what will happen in therapy. • therapy ▪ Treat you with respect. • respect ▪ Be careful to honor your privacy unless we need to disclose tell something in order to protect your safety or the safety of others. others Your expectations: • ▪ Be an active part of therapy. • therapy ▪ Share your ideas, thoughts, and feelings with your therapist. • therapist ▪ Tell the truth. • truth ▪ Respect BRAINS by not damaging the building, furniture, or other objects. • objects ▪ Talk in a respectful way to staff. • staff ▪ Listen to staff and cooperate with suggestions. suggestions Adults at BRAINS You have the right to: • ▪ Be treated with respect and compassion. • compassion ▪ Receive care in a clean, smoke-free setting. • setting ▪ Collaborate in assessment & treatment planning, including implementation of strategies in home, school, and/or work environments to enhance your functioning. • functioning ▪ Be free from mental, physical, sexual, and verbal abuse, neglect, and exploitation. • exploitation ▪ Have a family member or other representative participate in your treatment planning and care. You also have the right to restrict sharing of information about your care. • care ▪ Request treatment in any of BRAINS lines of service. However, your right to make decisions about your care does not mean you can demand treatment or services that are inappropriate or formal request for record reviewunnecessary. Fees may applyYour primary clinician will discuss these options with you. • Understand financial consequences of your care. Insurance coverage and health plans are often confusing. BRAINS acts to address insurance coverage issues, however, it is impossible for us to know the nuances of each policy, plan, or covered benefit. We will do our best to inform you of costs prior to rendered services and explain the outcome of insurance reimbursement as soon as the information is available to us. • ▪ Seek assistance from self-help or advocacy agencies. agencies Teens at BRAINS As parents/guardians, you have asked that BRAINS help teach your child to function at their highest potential. In order to do that, we need your help and promise to do our best to help your child and your family. We promise to: • ▪ Respect your ideas and feelings. • feelings ▪ Listen to what you say. • say ▪ Incorporate your ideas about goals and respect your input about the therapy process. • process ▪ Treat you with respect. • respect ▪ Honor your privacy unless we need to disclose tell something in order to protect your safety or the safety of others. others Your expectations: • ▪ Review records. Please ask a staff member to learn how to make a ▪ Be an active part of therapytherapy formal request for record review. • Fees may apply. ▪ Understand financial consequences of your care. Insurance coverage and health plans are often confusing. BRAINS acts to address insurance coverage issues, however, it is impossible for us ▪ Share your ideas, thoughts, and feelings with your therapist. • therapist ▪ Tell the truth. • truth ▪ Respect BRAINS by not damaging the building, furniture, or other objectsobjects to know the nuances of each policy, plan, or covered benefits. • We ▪ Talk in a respectful way to staff. • staff will do our best to inform you of costs prior to rendered services and explain the outcome of insurance reimbursement as soon as the information is available to us ▪ Listen to staff and cooperate with suggestions.

Your Expectations. Be an active participant in therapy, share your ideas, thoughts, and feelings with your therapist, tell the truth, respect BRAINS by not damaging the building, furniture, or other objects, listen and talk in a respectful way to staff, and cooperate with person-centered clinical suggestions. Client Rights You have the right to... • Be treated with respect and compassion. • Receive care in a clean and smoke-free environment. • Collaborate in assessment & treatment planning, including implementation of strategies in home, school, and/or work environments to enhance your functioning. • Be free from mental, physical, sexual, and verbal abuse, neglect, and exploitation. • Have a family member or other representative participate in your treatment planning and care along with the right to restrict the sharing of information about your care. • Request treatment in any of BRAINS lines of service. However, your right to make decisions about your care does not mean that you can demand treatment or services that are inappropriate or unnecessary. Your primary clinician will discuss these options with you. • Review your records. Please ask a staff member to learn how to make a formal request for record review. • Understand financial consequences of your care. Insurance coverage and health plans are often confusing. BRAINS acts proactively to address insurance coverage issues, however, it is impossible for us to know the nuances of each policy, plan, or covered benefit. We will do our best to inform you of costs ahead of time and explain the outcome of insurance reimbursement as soon as the information is available to us. • Seek assistance from self-help or advocacy agencies. • File a formal written or verbal complaint with the Client Rights Advisor or one of the owners. There are Grievance Forms available in the main waiting room at BRAINS. One can also be mailed to you upon request. Filing a grievance will not result in retaliation or dismissal from services. If your concern is not resolved to your satisfaction, you also have the right to file a complaint with the following organization: The Better Business Client Responsibilities It is expected that… • You, your family, and visitors are responsible to treat BRAINS staff and facility with respect. • You are expected to use respectful language and communication, addressing staff in a calm manner. Should you choose to swear, raise your voice, threaten, or use intimidation toward staff, volunteers, or other clients/visitors, you will be asked to leave the premises. • BRAINS does not allow any illegal drugs or weapons on the premises. Should our office be made aware of the presence of such substances &/or weapons, you will be asked to leave &/or proper authorities will be contacted. BRAINS Staff do not use seclusion or restraint at any time. • BRAINS is a drug (illegal & legal-see restrictions below) & smoke-free facility. No smoking (tobacco, smokeless, etc.) is allowed in the building or within sight of the building. • Out of respect to other clients and professionals, please do not carry on extended cell-phone conversations in the waiting rooms. Please do not leave children unattended in the waiting room. Support staff will not act as child-care providers or take responsibility for entertaining children. • You are responsible for providing a complete and accurate history to your clinician. This should include prior assessments, treatment, interventions, and past & current medications. In this way, the clinician can best assess and develop appropriate treatment. If it is necessary for a client or family member/s to hold a legal-prescription medication while on-site, they are asked to keep the medication/s in original packaging & keep them secure while in the building. • You are responsible to inform your clinician/s if you are showing signs of a contagious illness. It will be determined how to proceed with scheduled treatment. • You are responsible to follow the suggestions and advice provided during the course of treatment. You may also discuss your concerns with your clinician. If your refusal of treatment prevents us from providing appropriate care according to ethical and professional standards, we may need to end our relationship with you after giving you reasonable notice. • You are responsible for providing information about any unexpected difficulties, changes in circumstances, or other factors which may complicate the treatment process. covered benefit. We will do our best to inform you of costs ahead • You are responsible for maintaining your scheduled of time and explain the outcome of insurance reimbursement as soon as the information is available to us. • Seek assistance from self-help or advocacy agencies. • File a formal written or verbal complaint with the Client Rights Advisor or one of the owners. There are Grievance Forms available in the main waiting room at BRAINS. One can also be mailed to you upon request. Filing a grievance will not result in retaliation or dismissal from services. If your concern is not resolved to your satisfaction, you also have the right to file a appointments. Reminder calls are a courtesy. Please do not rely on reminder calls as confirmation of your appointment due to possible technical errors. • You are responsible to inform us of any changes in your insurance coverage. You are responsible for meeting any financial obligations agreed to, and for providing us with correct information about sources of payment. Criteria for Discharge A client can be discharged from services consistent with the legal and ethical standards for the profession. Criteria can include but is not limited to the following: ongoing violation of rules, consistently not attending scheduled appointments, unpaid account balances, abusive Bureau, xxxxx://xxx.xxx.xxx, Michigan Department of Community behavior/ language towards staff or other clients, etc. Health, Bureau of Health Systems, (000)-000-0000. Children at BRAINS As parents/guardians, you have asked that BRAINS help teach your unnecessary. Your primary clinician will discuss these options with you. child to function at their highest potential. In order to do that, we need• Review records. Please ask a staff member to learn how to make a need your help and promise to do our best to help your child and your family. We promise to: • Listen to what you say. • Listen to your ideas about goals and let you help decide what will happen in therapy. • Treat you with respect. • Be careful to honor your privacy unless we need to disclose something in order to protect your safety or the safety of others. Your expectations: • Be an active part of therapy. • Share your ideas, thoughts, and feelings with your therapist. • Tell the truth. • Respect BRAINS by not damaging the building, furniture, or other objects. • Talk in a respectful way to staff. • Listen to staff and cooperate with suggestions. Adults at BRAINS You have the right to: • Be treated with respect and compassion. • Receive care in a clean, smoke-free setting. • Collaborate in assessment & treatment planning, including implementation of strategies in home, school, and/or work environments to enhance your functioning. • Be free from mental, physical, sexual, and verbal abuse, neglect, and exploitation. • Have a family member or other representative participate in your treatment planning and care. You also have the right to restrict sharing of information about your care. • Request treatment in any of BRAINS lines of service. However, your right to make decisions about your care does not mean you can demand treatment or services that are inappropriate or unnecessary. Your primary clinician will discuss these options with you. • Review records. Please ask a staff member to learn how to make a formal request for record review. Fees may apply. • Understand financial consequences of your care. Insurance coverage and health plans are often confusing. BRAINS acts to address insurance coverage issues, however, it is impossible for us to know the nuances of each policy, plan, or covered benefit. We will do our best to inform you of costs prior to rendered services and explain the outcome of insurance reimbursement as soon as the information is available to us. • Seek assistance from self-help or advocacy agencies. Teens at BRAINS As parents/guardians, you have asked that BRAINS help teach your child to function at their highest potential. In order to do that, we need your help and promise to do our best to help your child and your family. We promise to: • Respect your ideas and feelings. • Listen to what you say. • Incorporate your ideas about goals and respect your input about the therapy process. • Treat you with respect. • Honor your privacy unless we need to disclose something in order to protect your safety or the safety of others. Your expectations: • Be an active part of therapy. • Share your ideas, thoughts, and feelings with your therapist. • Tell the truth. • Respect BRAINS by not damaging the building, furniture, or other objects. • Talk in a respectful way to staff. • Listen to staff and cooperate with suggestions.