Yellow Flowers

Terms and Conditions

PRACTICE POLICIES

The standard meeting time for psychotherapy is 53 minutes. It is up to you, however, to determine the length of time of your sessions. Requests to change the 53-minute session needs to be discussed with the therapist in order for time to be scheduled in advance.
 

Appointments and Cancellations
 

Please remember to cancel or reschedule 24 hours in advance. You will be responsible for the cancelation fee if cancellation is less than 24 hours. *Cancellations of re-scheduled session for the same week will be subject to a cancellation fee if original cancellation is NOT RECEIVED AT LEAST 24 HOURS 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.

 

Fees, Payment, Insurance
 

The agreed upon fee for each session will be $150 per 53-minute individual therapy, or $170 per family, or couple’s counseling. Fees are payable at the beginning of the session when services are rendered. For first time appointment, session will be charge upfront. When using your insurance, your co-pay will be collected at the beginning of the session. Therapists accepts all major credit cards, health flex, cash, or debit cards using secure practice portal. You will be requested to submit a credit card form to provide the credit card you want to use to reserve your first appointment and to make future payments.

 

On occasion, at the discretion of your therapist (e.g. initial assessments, family session, etc.) and the consent of the client, the session may be extended or previously arranged and the fee will be adjusted accordingly. A copy of receipt or a Superbill will be provided per your request to submit to your out-of-network insurance for reimbursement.
 

When using a HEALTH INSURANCE to pay for service, the amount of reimbursement and the amount of any co-payments or deductible depends on the requirements of your specific insurance plan. You should be aware that insurance plans generally limit coverage to certain diagnosable mental conditions. You should also be aware that you are responsible for verifying and understanding the limits of your insurance coverage. Although we’ll submit claims for payments for your services to your insurance company, we are unable to guarantee whether your insurance will provide payment for the services provided to you. In cases your insurance company does not reimburse service fees, client will be billed for the amount. Please discuss any questions or concerns that you may have about this with our therapist.

Please ask your therapist if you wish to discuss a written agreement that specifies an alternative payment procedure. If for some reason you find that you are unable to continue paying for your therapy, you should inform your therapist. Your therapist will help you to consider any options that may be available to you at that time.

Testifying in Court

 

If you become involved in any legal proceedings that require my participation, you will be expected to pay for all my professional time. This includes any preparation and transportation time, even if I am called to testify by another party. Because of the difficulty of legal involvement, I charge one and a half times (1.5x) my clinical rate per hour for all preparation, travel, and attendance (waiting and participation) at any legal proceeding. Having said this, I am not a certified child custody evaluator and will be unable to help you legally if this is your purpose in pursuing treatment with me.

 

Telephone Accessibility
 

If you need to contact me between sessions, please leave a message on my voice mail (805) 947-0984 I am often not immediately available; however, I will attempt to return your call within 24 hours. Please note that Face- to-face 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 and when possible via Telehealth (see Telehealth agreement). If a true emergency situation arises, please call 911 or go to any local emergency room.
 

Animals/Pets
 

Animals or pets are not allow into premises other than service animals covered under the Americans with Disabilities Act (ADA). Service animals are defined as animals who have been trained to perform a specific job or task. Emotional support animals are not covered under ADA and are not allowed in the premises.

Social Media and Virtual Communication.
 

Due to the importance of your confidentiality and the importance of minimizing dual relationships, I do not accept friend or contact requests from current or former clients on any social networking site (Facebook, LinkedIn, etc). I believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up when we meet and we can talk more about it.
 

Electronic Communication

I cannot ensure the confidentiality of any form of communication through electronic media, including (i.e. emails, text messages). If you prefer to communicate via email or text messaging for issues regarding scheduling or cancellations, I will do so. While I may try to return messages in a timely manner, I cannot guarantee immediate response and request that you do not use these methods of communication to discuss therapeutic content and/or request assistance for emergencies.
 

Online Therapy/ Telehealth /Telemedicine
 

Services by electronic means, including but not limited to telephone communication, the Internet, facsimile machines, and e-mail is considered telemedicine by the State of California. Under the California Telemedicine Act of 1996, telemedicine is broadly defined as the use of information technology to deliver medical services and information from one location to another. If you and your therapist chose to use information technology for some or all of your treatment, you need to understand that:

(1) You retain the option to withhold or withdraw consent at any time without affecting the right to future care or treatment or risking the loss or withdrawal of any program benefits to which you would otherwise be entitled.


(2) All existing confidentiality protections are equally applicable.


(3) Your access to all medical information transmitted during a telemedicine consultation is guaranteed, and copies of this information are available for a reasonable fee.


(4) Dissemination of any of your identifiable images or information from the telemedicine interaction to researchers or other entities shall not occur without your consent.


(5) There are potential risks, consequences, and benefits of telemedicine. Potential benefits include, but are not limited to improved communication capabilities, providing convenient access to up-to-date information, consultations, support, reduced costs, improved quality, change in the conditions of practice, improved access to therapy, better continuity of care, and reduction of lost work time and travel costs. Effective therapy is often facilitated when the therapist gathers within a session or a series of sessions, a multitude of observations, information, and experiences about the client. Therapists may make clinical assessments, diagnosis, and interventions based not only on direct verbal or auditory communications, written reports, and third person consultations, but also from direct visual and olfactory observations, information, and experiences. When using information technology in therapy services, potential risks include, but are not limited to the therapist's inability to make visual and olfactory observations of clinically or therapeutically potentially relevant issues such as: your physical condition including deformities, apparent height and weight, body type, attractiveness relative to social and cultural norms or standards, gait and motor coordination, posture, work speed, any noteworthy mannerism or gestures, physical or medical conditions including bruises or injuries, basic grooming and hygiene including appropriateness of dress, eye contact (including any changes in the previously listed issues), sex, chronological and apparent age, ethnicity, facial and body language, and congruence of language and facial or bodily expression. Potential consequences thus include the therapist not being aware of what he or she would consider important information, that you may not recognize as significant to present verbally the therapist.

Minors
 

The State of California provides confidentiality to minors seeking mental health treatment. Minors 12 years of age and older have many privacy rights similar to those of adults. Communications between therapists and those under the age of 18 are confidential. However, parents and other guardians who consent for their child’s treatment are often involved in their treatment. Due to this, discussion of treatment progress of a minor client with their parent or caretaker may occur for safety and other considerations of client’s well being. Clients who are minors and their caregivers, are urged to discuss any questions or concerns that they may have regarding this topic.

 

Duty to Protect - Duty to Report
 

Florecer Therapy abide by California Law, which requires incidences of “reasonable suspected child abuse and abuse of elders or dependent adults to be reported to California authorities (California Law-Penal Code Article 2.5, Paragraph 11166). Every mental health provider are mandated to report any incidences of “reasonable child abuse” (physical, neglect, emotional, or sexual) and any abuse of elders or dependent adults. Prior to making a report to anyone concerning “reasonably suspected child abuse” or abuse of elders or dependent adults, your therapist will first make a concerted effort to shared with the client, the therapist’s intention to report.
 

Confidentiality and privileged communication remain rights of all clients. However, some courts have held if an individual intends to take harmful, dangerous, or criminal action against another human being, or oneself, it is the therapist’s duty to warn appropriate individuals of such intentions.
 

Prior to informing anyone who should be warned (i.e. police, Mobil psychiatric team, presumed victim) will first make a concerted effort to share with the client the therapist intension to warn.
 

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. You may also seek referrals from your health insurance.
 

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 and it will be understood that you have terminated treatment. I shall have no further obligation to you once treatment has been terminated.