OUR  PRACTICE  POLICIES

AGREEMENT REGARDING PROFESSIONAL SERVICES AND BUSINESS POLICIES
Welcome to Better Self Better Life LCSW Inc. This document contains important information about professional services and business policies. Please read it carefully and let me know if you have any questions so that we can discuss them. After you have reviewed this document, please sign it.

PSYCHOLOGICAL SERVICES
Cognitive-behavioral psychotherapy involves jointly setting treatment goals, weekly agendas, and discussing the techniques to be used as part of the treatment. There are many different cognitive and behavioral techniques that may be helpful in dealing with the problems that you hope to address. If you have any questions about my procedures, we should discuss them whenever they arise. Psychotherapy calls for an active effort on your part. For the therapy to be most effective, you will have to work on things we talk about both during our sessions and at home.

Psychotherapy can have benefits and risks. Since therapy often involves discussing difficult aspects of your life, you may experience uncomfortable feelings like sadness, guilt, or anger. On the other hand, psychotherapy has also been shown to have many benefits. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress. But there are no guarantees of what you will experience.

My process is to conduct an initial 90 min. evaluation with a 45 min follow up session to complete the evaluation. At the end of these two sessions, we can both decide if I am the best person to provide the services you need to meet your treatment goals. It is important for the intake process to be as thorough as possible so we may devise the best treatment plan to meet your specific goals. Therefore, it is highly recommended that you provide me with information of collateral contacts (e.g., physicians, psychiatrists, educators, previous treatment providers), for which a signed authorization form (Release of Information Form) will allow us to exchange information.

Once the intake process is completed, we will discuss my treatment recommendations with you. If psychotherapy begins, I usually schedule one 45-minute session per week at a time we agree on. If you would like to change the length of the session or frequency of sessions, please discuss this with me so that, if agreed upon, time can be arranged to accommodate this in the schedule.

INSURANCE ISSUES
If you have a health insurance policy, it may provide some coverage for mental health treatment. Upon request, I will provide a receipt – (Called a Super Bill) with the dates of service, fees paid, service codes and a working diagnosis to assist you in receiving the benefits to which you may be entitled. A super bill is not a guarantee of reimbursement. You (not your insurance company) are responsible for full payment of fees. Clients are encouraged to call their insurance company before the start of treatment to inquire about their out of network reimbursement benefits. 

You should also be aware that most insurance companies require you to authorize me to provide them with a clinical diagnosis. Sometimes I must provide additional clinical information such as treatment plans or summaries, or copies of the entire record (in very rare cases). This information will become part of the insurance company files. Though all insurance companies claim to keep such information confidential, I have no control over what they do with it once it is in their hands. At your request, I will let you know if any information beyond a diagnosis code is required or provide you with a copy of any report I submit.

PHONE CONTACT I am often not immediately available by telephone. When I am unavailable, you can leave messages on my confidential voicemail (831-223-9399- phone or text). I will attempt to return your call within 24- 48 hours. Please do not leave urgent /crisis information on this voicemail. If you or a family member is in crisis, call 911 or immediately proceed to your local emergency room. Please note that Face- to-face virtual sessions are highly preferable to phone sessions. However, in the event that you are out of town, sick or need additional support, phone sessions are available.

EMERGENCY CONTACT INFORMATION
If you are unable to reach me and feel that it is an emergency, contact your psychiatrist or physician, call 911, or go to the nearest local emergency room. If something is less urgent and can wait 24 - 48 hrs, please feel free to leave me a message and I will get back to you as soon as I am able.

PROFESSIONAL RECORDS
The laws and standards of my profession require that I keep treatment records for six years.

PAYMENT
The fees are as follows:
Telehealth - 90 min. Initial Intake Fee (90791) : $275
Telehealth - 45 Follow Up Session Fee (90834): $200
Telehealth - 50 min. Group Therapy Session Fee (90853): $100
Concierge - 90 min. Initial Intake Fee (90791): $450
Concierge - 45 min. Follow Up Session Fee (90834): $300

You will be expected to pay for each session at the time it is held and secured with a credit card on file. In general, credit cards are preferred to payment by check. You may pay by check or cash. Please note in the case of a returned check, you will be charged a check nonsufficient funds fee of $25 for any returned check for any reason or for special handling.

CANCELLATION AND RESCEDULING
Cancellations and re-scheduled sessions will be subject to a full charge if NOT RECEIVED AT LEAST 48HOURS IN ADVANCE. This is necessary because a time commitment is made to you and is held exclusively for you. If you are late for a session, you may lose some of that session time. I will be available at any time during the duration of your appointment if you are late.

TERMINATION
Ending relationships can be difficult. Therefore, it is important to have a termination process in order to achieve some closure. The appropriate length of the termination depends on the length and intensity of the treatment. I may terminate treatment after appropriate discussion with you and a termination process if I determine that the psychotherapy is not being effectively used or if you are in default on payment. I will not terminate the therapeutic relationship without first discussing and exploring the reasons and purpose of terminating.

If therapy is terminated for any reason or you request another therapist, I will provide you with a list of qualified psychotherapists to treat you. You may also choose someone on your own or from another referral source.

Should you fail to schedule an appointment for three consecutive weeks, unless other arrangements have been made in advance, for legal and ethical reasons, I must consider the professional relationship discontinued.