Consent for Treatment and Limits of Liability

Limits of Services and Assumption of Risks:  

Therapy sessions carry both benefits and risks. Therapy sessions can significantly reduce the amount of distress  someone is feeling, improve relationships, and/or resolve other specific issues. However, these improvements and  any “cures” cannot be guaranteed for any condition due to the many variables that affect these therapy sessions.  Experiencing uncomfortable feelings, discussing unpleasant situations and/or aspects of your life are considered  risks of therapy sessions.  

Limits of Confidentiality:  

What you discuss during your therapy session is kept confidential. No contents of the therapy sessions, whether  verbal or written may be shared with another party without your written consent or the written consent of your legal  guardian. The following is a list of exceptions:  

Duty to Warn and Protect  

If you disclose a plan or threat to harm yourself, the therapist must attempt to notify your family and notify  legal authorities. In addition, if you disclose a plan to threat or harm another person, the therapist is  required to warn the possible victim and notify legal authorities.  

Abuse of Children and Vulnerable Adults  

If you disclose, or it is suspected, that there is abuse or harmful neglect of children or vulnerable adults (i.e.  the elderly, disabled/incompetent), the therapist must report this information to the appropriate state agency  and/or legal authorities.  

Prenatal Exposure to Controlled Substances  

Therapists must report any admitted prenatal exposure to controlled substances that could be harmful to the  mother or the child.  

Minors/Guardianship  

Parents or legal guardians of non-emancipated minor clients have the right to access the clients’ records.  

 Insurance Providers  

 Insurance companies and other third-party payers are given information that they request regarding services  to the clients.  

The type of information that may be requested includes: types of service, dates/times of service, diagnosis, treatment  plan, description of impairment, progress of therapy, case notes, summaries, etc. 

Cancellation Policy

If you are unable to attend an appointment, we request that you provide at least 24 hours advanced notice  to our office. Since we are unable to use this time for another client, please note that you will be billed for  the entire cost of your scheduled appointment if it is not timely cancelled, unless such cancellation is due  to illness or an emergency.  

For cancellations made with less than 24 hour notice (unless due to illness or an emergency) or a  scheduled appointment that is completely missed, you will be mailed a bill directly for the full session  fee.  

We appreciate your help in keeping the office schedule running timely and efficiently.