Welcome to the Center for Holistic Mental Health and Sexual Therapy, LLC (CHMHST). It’s my goal to provide the highest quality mental health care possible, and to provide an atmosphere of mutual respect and trust. This document is designed to explain the rights and obligations for you, the client, and myself, the therapist. Maryland Law enforces some of these rights and laws; others are established herein by contractual agreement between you the client and CHMHST your care provider. Any concerns or questions regarding the matters stated herein should be discussed directly with me.
All information and communication between you and me in the course and continuance of the psychotherapeutic relationship will be treated as strictly confidential. As the client, you control whether or not I may disclose confidential information. You have the power to choose to waive confidentiality. There are exceptions to confidentiality mandated by the State of Maryland Law. Under the following circumstances I am legally bound to breach confidentiality:
Information from a session where a member of a couple wants to see me 1 on 1 for a session, confidentiality will apply and only information with permission will be revealed to the partner in a couple’s session.
Clients generally wish to establish certain limited waivers of confidentiality. Unless otherwise specified in writing you agree to the following limited waivers:
Your session will start on time whether you are here or not. Arriving after our scheduled session starts, the time missed will be charged as if you where there and the full fee will be assessed.
When you call my office, I will answer the call unless I am in session or away from my desk. Please leave a message and I will do everything in my power to return your call within next 24 hours. If you find yourself in an emergency situation and need to talk immediately, please hang up and dial 911 or go to your nearest emergency room or the suicide prevention hotline (800) 273-8255
Each 60-minute session will cost 120 dollars. Payment is expected at the end of each session. Cash, personal checks, and most credit cards are acceptable forms of payment. If special circumstances exist that render it difficult for you to make payment as expected, please discuss it with me.
All payments must be received at the end of each session. If unable to pay at the end of a session, a two session grace period after which if no payment is received for the outstanding balance, a third session will not be scheduled until the previous two sessions are paid in full.
Because of the vast number of insurance companies that have separate forms and procedures, I do not bill insurance companies for your visits. I would be happy to issue you a “super bill” (receipt) that will provide all the information you will need for reimbursement from your insurance company for services rendered so you can submit directly to your insurance company.
A 24 hour notice of cancellation is required. Please recognize that when you make an appointment this time is being reserved for you. If you miss an appointment that is time that could have been scheduled for another client. Therefore, it is necessary to charge you the full 120 dollars for any appointments missed without 24-hour notice of cancellation.
It is important for you to arrive on time for your scheduled appointment. Therefore, should you arrive late, your session will still end at the scheduled time, and you will be billed for the entire session.
Inclement weather is a concern in DC area, especially snow. My office will close if the Federal Government is closed for weather related reasons. Sessions will be considered canceled and no cancellation fee will be issued. If the government is open and you are unable to make the session due to weather please contact me to make arrangements. If no contact is made, a no show fee will be issued.
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