PRACTICE POLICIES

NO SHOWS AND CANCELLATIONS

Requests to cancel or reschedule your appointment must be received 24 hours in advanced of the scheduled appointment. If a request to cancel or reschedule an appointment is received short of 24 hours advanced notice of the scheduled appointment, you will be responsible for payment of the full session fee.

The standard meeting time for psychotherapy is 50 minutes. It is up to you, however, to determine the length of time of your sessions. Requests to change the 50-minute session need to be discussed with your Provider in order for time to be scheduled in advance. If you choose to end your session sooner than the scheduled length of time, you will be responsible for the full session fee as scheduled.

A $10.00 service charge will be charged for any checks returned for any reason for special handling.

PHONE ACCESSIBILITY

If you need to contact your Provider between sessions, email communication is preferred. However, if you choose to call, please leave a voice mail message or send a text message. The Practice is not often not immediately available; however, we will attempt to return your call or text 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. If a true emergency situation arises, please call 911 or visit any local emergency room.

SOCIAL MEDIA AND TELECOMMUNICATION Due to the importance of your confidentiality and the importance of minimizing dual relationships, your Provider will not accept friend or contact requests from current or former clients on any social networking site (Facebook, LinkedIn, etc). You may follow the Practice’s business accounts on social networking sites. However, it is important to be aware that 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 you meet you Provider and you can discuss it further.

ELECTRONIC COMMUNICATION

The Practice cannot ensure the confidentiality of any form of communication through electronic media, including text messages. If you prefer to communicate via email or text messaging for issues regarding scheduling or cancellations, your Provider will do so. While The Practice and your Provider may try to return messages in a timely manner, The Practice and your Provider 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.

“Telehealth services” means the use of telecommunications and information technology to provide access to health assessments, diagnosis, intervention, consultation, supervision, and information across distance. “Telehealth services” includes the use of such technologies as telephones, facsimile machines, electronic mail systems, store-and-forward technologies, and remote patient monitoring devices that are used to collect and transmit patient data for monitoring and interpretation. If you and your Provider 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 your Provider gathers within a session or a series of sessions, a multitude of observations, information, and experiences about the client. Providers 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 your Provider’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 your Provider not being aware of what they would consider important information, that you may not recognize as significant to present verbally to your Provider. Another potential risk or consequence is the unexpected failure of technology ie internet connectivity, power failure, etc and you will still be financially liable for the full payment of rendered services and time regardless of any technological disruption to the session.

MINORS If you are a minor, your parents may be legally entitled to some information about your therapy. Your Provider will discuss with you and your parents what information is appropriate for them to receive and which issues are more appropriately kept confidential.

PAYMENT AND FEES

The fee for therapy varies by state and by service code. The fee for your therapy service will be discussed and agreed upon prior to your first appointment. If you fail to pay your balance, I reserve the right to discontinue our professional relationship.

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. Your Provider may terminate treatment after appropriate discussion with you and a termination process if your Provider determines that the psychotherapy is not being effectively used or if you are in default on payment. Your provider 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, The Practice 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, your Provider must consider the professional relationship discontinued. If you should choose to re-engage in therapy thereafter, you may be subject to being placed on the waiting list.

How We Use Al Tools Al tools are used strictly for administrative and supplementary support tasks under the direct supervision of your therapist. These tools do not provide therapy, make independent clinical decisions, or interact with you directly. The specific purposes for which we may use Al now and in the future include:

• Assisting your therapist in drafting and organizing session notes;

• Managing appointment scheduling and/or sending reminders;

• Processing billing and insurance claims;

• Analyzing data to identify therapy trends and track progress, which is always reviewed by your therapist;

• Analyzing business information and generating reports or trends to help me manage my business; or

• Helping to identify and organize external resources or referrals for your use.

How We DO NOT Use Al Tools To be clear, we do not use Al to:

• Make independent therapeutic decisions or diagnoses;

• Communicate with you directly to provide therapeutic advice;

• Generate treatment recommendations without the direct review, approval, and input of your licensed therapist; or

• Detect or interpret your emotions or mental state.

Consent for Session Transcription (If Applicable) To help create accurate and detailed session notes, your therapist uses an Al tool called Note Taker that transcribes our sessions and then prepares a draft progress note. Note Taker is a feature in the Electronic Health Record and practice management platform that I use from SimplePractice.

Your Rights and Confidentiality
Confidentiality: All information, including any data processed by an Al tool, is treated as part of your confidential health record and is protected by the same privacy and security standards as all other aspects of your care, including HIPAA.
• SimplePractice and its Note Taker tool are HIPAA-compliant and HITRUST certified.
• All audio-recordings of therapy sessions through Not Taker are immediately deleted as soon as a transcript is created, generally within minutes of a session ending.
• Transcripts that are created through Note Taker are only retained for the shorter of 7 days or when the progress note is signed and locked by your therapist. After that, they are permanently deleted.
• During the time that transcripts are available in Note Taker, they always remain confidential and secure, and are only available for your therapist's use to verify the accuracy of the progress note. They are not used for any other purpose.

Right to Revoke Consent: Your consent is voluntary. You have the right to withdraw this consent at any time by notifying your therapist in writing. Revoking your consent will not affect your ability to receive therapy services.

Mind Care Therapy, LLC

300 Main St. Ste 65 #1039

Madison, NJ 07940

(201) 357-7272