Your inner safety and balance is my goal.
Your Privacy and Confidentially is at the core of that.

The Law protects the privacy of communication between us.
In most situations, I can only release information about your treatment to others if you sign a written Authorization form that meets certain legal requirements imposed by HIPPA.
I will not share any of your personal information to anyone unless it is
a legal action or stated otherwise.

Your Confirmed Appointment is an Acceptance & Confirmation to This Agreement and
Provides Consent to the following activities:

• I may occasionally find it helpful to consult other health and mental health professionals about a case. During a consultation, I make every effort to avoid revealing the identity of my client. The other professionals are also legally bound to keep the information confidential.

• You should be aware that I practice with other mental health professionals. In most cases, I need to share protected information with these individuals for both clinical and administrative purposes, such as scheduling, billing and quality assurance. All mental health professionals are bound by the same rules of confidentiality. All staff members are bound by this same training about protecting your privacy and have agreed not to release any information outside of the practice without the permission of a professional staff member.

• If a client threatens to harm himself/herself, I may be obligated to seek hospitalization for him/her or to contact family members or others who can help provide protection.

There are some situations where I am permitted or required to disclose information without either your consent or authorization:

• If you are involved in a court proceeding and a request is made for information concerning my professional services, such information is protected by the psychologist‐patient privilege law. I cannot provide any information without your written authorization, or a court order. If you are involved in, or contemplating litigation, you should consult with your attorney to determine whether a court would be likely to order me to disclose information.

• If a government agency is requesting the information for health oversight activities, I may be required to provide it for them.

• If a client files a complaint or lawsuit against me, I may disclose relevant information regarding that client in order to defend myself.

• If I have reason to believe that a child has been abused, the law required that I file a report with DFACS. Once such a report is filed, I may be required to provide additional information.

• If I have reasonable cause to believe that a disabled adult or elder person has been abused, I am required to report that to the appropriate agency. Once such a report is filed, I may be required to provide additional information.

• If I determine that a client presents a serious danger of violence to another, I may be required to take protective actions. These actions may include notifying the potential victim, and/or contacting the police, and/or seeking hospitalization for the client. If such a situation arises, I will make every effort to fully discuss it with you before taking any action and I will limit my disclosure to what is necessary.
*Please feel free to discuss any concerns or questions you may have about your confidentiality.

Minors & Parents

Patients under 18 years of age, who are not emancipated, and their parents should be aware that the law allows parents to examine their child’s treatment records unless we believe that doing so would endanger the child or we (patient, therapist, and parents) agree to do otherwise. Because privacy in psychotherapy is often crucial to successful progress, particularly with teenagers, it is sometimes our policy to request agreements from parents that they consent to give up their access to their child’s records. If the parent agrees, during treatment we will provide them only with general information about the progress of the child’s treatment and his/her attendance at scheduled sessions. Any other communication will require the child’s authorization, unless we feel that the child is in danger or is a danger to someone else. If that is the case, the counselor will notify the parents of their concern. Before giving parents any information, your practitioner will discuss matters with the child. If possible, and do their best to handle any of their objections.

Appointments

Each appointment is traditionally a 60 minutes, unless specially arranged by your scheduled appointment or the practitioner. Once an appointment is scheduled, it is your responsibility to keep track of the dates and times of your appointments. If you must cancel your appointment or need to reschedule, please phone or email at least 24 hours in advance of your scheduled appointment. A late cancellation fee will be billed to you for the time that was reserved for your appointment. This fee is typically 100% of the fee for the scheduled appointment. We reserve the right to terminate treatment with a client for failure to show up at two or more appointments. In cases of emergencies and/or hospitalizations, please discuss concerns with your practitioner, as reducing/waiving this fee is at the discretion of the practitioner.

Professional Fees

The hourly fees for services vary. Please see offerings page for details.

A deposit of 50% must be placed at the time of booking to reserve our time.

Events over three hours, payments must be made in full prior to our session, any accumulated time over that will be due prior to release of images.

Accepting : Cash, Venmo, Cashapp + Paypal

Agreement

Your confirmed appointment booking indicates that you have read this agreement and consent to treatment by your practitioner under these terms and conditions. This agreement also serves as an acknowledgment that you agree to and understand the HIPPA privacy guidelines.