Consent for Therapy (continued)
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   Clinical Overview
   Benefits and Risks of Treatment, Office Policies
   Confidentiality and Limits to Confidentiality, Complaints

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Benefits and Risks of Treatment

The risks or potential side effects of participating in psychotherapy may include increased levels of stress and anxiety, escalation of undesired behaviors, relationship disruption and emotional reactivity.
The benefits of outpatient psychotherapy may include improved functioning in your personal and professional relationships, improved communication skills and a reduction in the symptoms that led you to seek therapy in the first place.

Office Policies

1. Payment in the form of check or cash is due at each appointment.

2. Insurance claims are filed only with certain networks but a statement can be provided upon request. Most insurance plans require a diagnosis as part of filing a claim. This diagnosis will be discussed with the client prior to providing a statement.

3. Cancellation of an appointment for Individual or Couples Therapy requires 24-hours advance notice. (Advance cancellation of Monday morning appointments should be made by Sunday.) Otherwise, the client will be charged for the missed session. This cancellation policy does not apply to Group therapy. Clients participating in Group therapy are charged whether or not they attend (including vacation absences). Emergency circumstances (i.e., hospitalization, accident, a death in the family) will be addressed on an individual basis.

4. If fees are not paid within the above terms, the client’s account may be turned over to a collection agency.

5. Session duration is sixty (60) minutes. Sessions longer than 60 minutes will be prorated accordingly based upon my per-hour rate. (After-hours or emergency calls will be billed on the same basis.)

6. In the event of my absence, I will provide clients with information regarding the availability of a therapist on call.

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