Rescheduled or Missed Sessions
Appointments must be cancelled or rescheduled with at least 48-hour notice, or you will be responsible for the FULL FEE of the appointment, regardless of the need for cancellation or lateness. You are paying for reserving the time of your scheduled sessions, regardless of whether you attend or not. Two missed, late cancelled, or late rescheduled appointments, even when paid in full, are grounds for discussing discharge from our practice.
If availability exists and if you are interested, you may have the opportunity for a lower fee option by working with one of our psychiatric registered nurses, who are extensively supervised and guided by our clinicians. Psychiatric nurses are currently board-certified registered nurses obtaining clinical experience for completing their degree to become nurse practitioners and are not yet licensed prescribing clinicians.
When working with a nurse, all treatment recommendations/medications will be discussed with and approved by the supervising NP or MD. Working with a nurse is optional, and you are under no obligation to work with a nurse. However, if you do choose to work with a nurse, please note that your care may need to be transferred to a different nurse or clinician, as the nurses’ availability is dependent upon policies set by their program director outside of this practice. In general, we work with the same nurses for one full school year, so most clients who meet with nurses transfer their care to someone else once a year at the end of the school year.
Your work with us can range from time limited or short-term to long-term work. You are always free to conclude your treatment at any point and for any reason. There may also be times when our practice chooses to conclude treatment, with some of the reasons being:
•A client having met goals as indicated by the client’s treatment plan and not actively working on any other goals with their clinician.
•The initial treatment plan decided upon by the clinician and client was time limited and has concluded.
•A client failing to communicate with staff about an overdue balance even after attempts from the practice to open a dialogue about it.
•A client not responding to the clinician and/or the practice and not scheduling sessions.
•Even though your treatment plan is collaborative, a client not being able or willing to work with clinician in recommended treatment options in a way that we believe could be potentially harmful.
•The clinician feeling that the client and clinician are not a good fit.
•The client being unable, for any reason, to meet the expectations outlined in our practice policies.
HIPAA Compliance Privacy Notice
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
You have the right to:
•Get a copy of your paper or electronic medical record.
•Correct your paper or electronic medical record.
•Request confidential communication.
•Ask us to limit the information we share.
•Get a list of those with whom we have shared your information.
•Get a copy of this Privacy Notice.
•Choose someone to act on your behalf.
•File a complaint if you believe your privacy rights have been violated.
You have some choices in the way we use and share information, if we:
•Tell family and friends about your condition.
•Share information in a disaster relief situation.
•Share information for marketing, sales, or fundraising purposes.
Our Uses and Disclosures
We may use and share your information as we:
•Run our organization.
•Bill for your services.
•Help with public health and safety issues.
•Comply with the law.
•Address workers’ compensation, law enforcement, and other government requests.
•Respond to lawsuits and legal actions.
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get a copy of your paper or electronic medical record.
•You can ask to see or receive a paper or electronic copy of your medical record and other health information we have about you. Ask us how to do this.
•We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Correct your paper or electronic medical record.
•You can ask us to correct your health information that you think is correct or incomplete. Ask us how to do this.
•We may deny your request, but we will tell you why in writing within 60 days.
Request confidential communication.
•You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
•We will agree to all reasonable requests.
Ask us to limit the information we share.
•You can ask us not to use or share certain parts of your health information for treatment, payment, or our operations.
•We are not required to agree to your request, and we may deny it if it would affect your care.
•If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will agree to your request, unless a law requires us to share that information.
Get a list of those with whom we have shared your information.
•You can ask for a list (”accounting”) of the times we have shared your health information for six years prior to the date you ask, with whom we shared this information, and why.
•We will include all the disclosures except those about treatment, payment, and health care operations, and certain other disclosures (such as any you requested us to make). We will provide one accounting a year for free, but will charge a reasonable, cost-based fee if you request another within 12 months.
Get a copy of this Privacy Notice.
•You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose someone to act on your behalf.
•If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
•We will make sure the person has this authority and can act on your behalf before we take any action.
File a complaint if you believe your privacy rights have been violated.
•You can complain if you feel we have violated your rights by contacting us.
•You can file a complaint with the US Department of Health and Human Services Office for Civil Rights by sending a letter 200 Independence Avenue SW, Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
•We will not retaliate against you for filing a complaint.
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
•Share information with your family, close friends, or others involved in your care.
•Share information in a disaster relief situation.
In these cases, we never share your information unless you give us written permission:
•Sale of your information.
•Most sharing of psychotherapy notes.
Our Uses and Disclosures
How do we typically use or share your health information?
To treat you.
•We can use and share your health information with other professionals who are treating you.
To run our organization.
•We can use and share your health information to run our practice or improve your care, and contact you when necessary.
To bill for services.
•We can use and share your health information to bill and get payment from health plans or other entities.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually to contribute to the public good, such as public health and research. We have to meet many legal conditions before we can share your information for these purposes. For more information, visit www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
To help with public health and safety issues.
•Helping with product recalls.
•Reporting adverse reactions to medications.
•Reporting or suspecting abuse, neglect, or domestic violence.
•Preventing or reducing a serious threat to anyone’s health or safety.
To perform research.
•We can use your share your information for health records.
To comply with the law.
•We will share information about you if state or federal laws require it, including the Department of Health and Human Services, if it needs to confirm that we are complying with federal privacy law.
To address workers’ compensation, law enforcement, and other government requests.
•For workers’ compensation claims.
•For law enforcement purposes or with a law enforcement official.
•With health oversight agencies for activities authorized by law.
•For special government functions, such as military, national security, and presidential protective services.
To respond to lawsuits and legal actions.
•We can share health information about you in response to a court or administrative order, or in response to a subpoena.
•We are required by law to maintain the privacy and security of your protected health information.
•We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
•We must follow the duties and privacy practices detailed in this notice and give you a copy of it.
•We will not use or share your information other than as describd here, unless you give us written permission. If you give us permission, you may change your mind at any time. Let us know in writing if you change your mind. For more information, visit
Changes to the Terms of This Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request and on our website.