Welcome. This document (the Agreement) contains important information about our professional services and business policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law that provides new privacy protections and patient rights with regard to the use and disclosure of your Protected Health Information (PHI) used for the purpose of treatment, payment, and health care operation. HIPAA requires that we provide you with a Notice of Privacy Practices (the Notice) for use and disclosure of PHI for treatment, payment, and health care operations. The Notice, which you are given with this Agreement, explains HIPAA and its application to your personal health information in greater detail. The law requires that we obtain your signature acknowledging that we have provided you with this information. Although these documents are long and sometimes complex, it is very important that you read them carefully before your treatment here. We can discuss any questions you have about the procedures during session. You may revoke this Agreement in writing at any time. That revocation will be binding on us unless we have taken action in reliance on it; if there are obligations imposed on us by your health insurer in order to substantiate claims made under your policy; or if you have not satisfied any financial obligations you have incurred.

Appointments: Appointments are usually scheduled 1 hour and 1/2 hour sessions. Counseling is a time sensitive activity and your appointment is reserved specifically for you. If you must cancel a session or reschedule, please call 24 hours before the appointment time. Cancellations with less than 24 hours notice will be charged one-half your regular fee. If you fail to show up for your scheduled appointment without notifying us ahead of time, you will be held responsible for the full fee of the missed appointment.

Business Hours: My business hours are generally from 9:00 am to 5:00 pm Monday through Friday. However, hours may vary according to each session. I have voicemail available to you anytime. If you leave a message after hours or on weekends, it will likely be the next business day before we are able to return your call. However, if you feel that you need immediate assistance after-hours, you should contact the Crisis Center at 323-7777, or emergency services.

Fees and Payment: Your fee is based on the session itself. Payment is expected at the time of session. Paypal and Zelle are preferred methods of payment. If you have concerns regarding your payment, please contact me before booking.

Your Rights: HIPAA provides you with new or expanded rights with regard to your Clinical Record and disclosure of Protected Health Information. These include requesting that we amend your record; requesting restrictions on what information from your Protected Health Information that you have neither consented to nor authorized, determining the location to which protected disclosures are sent; having any complaints you make about our policies and procedures recorded in your records; and the right to a copy of this Agreement and the Notice of Policies and Practices to Protect the Privacy of Your Health Information form.