Welcome: The following information is provided to acquaint you with the policies of my private practice. Please, read carefully. Please, discuss any questions you may have about this agreement with me before you sign it.
Appointments: All psychotherapy sessions are 50 minutes unless we plan in advance to have a longer session. In most cases, you will be seen on a weekly basis or otherwise agreed upon. If you are late to your session, we will still end on time. If I am late, you will receive the full time.
Insurance and Monthly Statements: I am a provider for Ambetter, MMP/Allwell from Superior Healthplan, and Behavioral Health Medicaid/CHIP. If I don’t accept your insurance, I can provide you with a monthly statement/Superbill that you can submit to your insurance company if you have “out of network” benefits.
Fees: Payment is due at the beginning of your appointment so that we can spend the entire time focusing on your therapy. The fee for individual sessions is $100 and $125 for a couple/family session. I accept payment by check, cash, Venmo.
Cancellations & Rescheduling: Your appointment time is reserved for you. When you give me a full 24 hours advance notice of your cancellation by phone or by email there will be no charge.
IF YOU MISS YOUR APPOINTMENT OR CANCEL LESS THAN
A FULL 24 HOURS IN ADVANCE YOU WILL BE RESPONSIBLE
FOR THE FULL FEE FOR THIS APPOINTMENT.
Messages: My office phone is answered and messages received 24 hours a day at 512-541-8207 office. Always leave the phone numbers where you may be reached.
E-Mail: Be aware that e-mail is not a secure form of communication and your privacy cannot be guaranteed. Any communication regarding the content of your therapy sessions should preferably be done in person, not by e-mail. I do not engage in e-mail discussions with clients about their therapy.
Confidentiality: No information about the content of your therapy sessions will be communicated to anyone without your expressed and written authorization. The only exceptions to this are cases of child or spousal abuse or suicidal or homicidal emergency. I will give you an additional HIPPA statement for your review and signature.
Emergencies: If you need to reach me between sessions, you may call me on my cell phone at (512) 541-8207. I provide up to 15 minutes per week at no charge. Any phone calls with clients, family, professionals, and treatment facilities above the weekly limit will be charged my regular rate. If you are experiencing a psychiatric emergency, please, contact your physician, the Travis County Mental Health Hotline 512-703-1390, go to the nearest hospital emergency room, or call 911.
Other Services: Fees for written reports are based on the amount of time required to complete the report. I have a separate fee schedule for written reports, hospital and home visits and services related to legal matters, such as depositions, court appearances, etc.
Termination: If you begin therapy with me, I ask that if you decide to stop your therapy at any time, it is important that you do this in person with me rather than by phone, letter, voice mail or text. As with any relationship, in therapy it is important to begin and end in a direct and honest way in order to feel positively.