A clear framework for my practice avoids misunderstandings, and helps to build a well-defined structure vital to effective treatment.
All information between Psychologist and patient is held strictly confidential unless:
(1) the patient authorizes release of information with a signature; (2) the Psychologist is
ordered by a court to release information; (3) the patient presents a physical danger to self or
others; (4) child abuse or neglect is suspected. In the latter two cases, I am required by law to
inform potential victims and legal authorities so that protective measures can be taken.
Upon request, this office will provide an insurance claim form for you to submit to your
insurance company. The insurance company will then reimburse you directly, according to the
terms of your contract.
Fees for psychotherapy and consultation sessions are due and to be paid at each session. Other
services such as report writing, attendance at meetings, and telephone conversations longer
than 5 minutes are billed on a prorated basis.
Cancellations and Missed Appointments
Because the appointment time is reserved exclusively for you, you are responsible for it, and
will be charged for any missed appointments and for cancellations with less than 24 hours of
advance notice. In the event of a late cancellation (with less than 24 hours of advance notice),
it is to your benefit to notify me immediately: If I am able to fill your appointment time, you
are no longer responsible for it. Of course, there is no guarantee I will be able to fill your time,
and if I am unable to do so, you will be charged for the late cancellation.