CLIENT INFORMATION SHEET
INDIVIDUAL SESSIONS will be approximately 50 minutes, beginning from the scheduled time of the appointment. If the beginning of the session is delayed by me, I will try to ensure the scheduled 50 minutes, will make a financial adjustment, or will reschedule the session.
CONFIDENTIALITY I will not disclose information about you or your therapy to anyone without your written permission. The exceptions to this would be: if I believe you were in danger to yourself or to others; if under a legal subpoena (in which case you would be notified); or if I am receiving consultation on my work. I keep notes and records for my own purposes and will be glad to discuss them if you wish.
PAYMENT The fee for individual sessions is $100/session and groups is $45/session. Payment is expected at the time of the session unless other arrangements have been made. Clients will receive a receipt after each session which can be submitted to an insurance company for potential reimbursement. At no time is it possible to accumulate a bill over $300. Please ask if you have any questions about policy, or about the extent and procedures of your insurance policy. I will try my best to work with you and your plan.
BILLING is handled by Kathi Miller of Accountrack Medical Services. Any questions about your account should be directed to Kathi, at 800 269 3901.
CANCELLATIONS I appreciate as much advance notice of an appointment cancellation as possible. There is a $65 fee for any session cancelled with less than 24 hours notice unless there is a sudden serious illness of family emergency. Please note that there is no third party reimbursement for canceled sessions.
TELEPHONE COVERAGE The telephone is answered by an answering machine which is checked regularly during the work day, and at regular intervals during non-work hours. Phone calls will be returned as soon as possible. Although my home phone number is available in the telephone book in case of emergency, I am not available to receive or to return calls after l0 PM or before 7 AM in the morning. In case of an emergency, call CONTACT (761 9100) or CRISIS INTERVENTION (577 2484) both of which have 24-hour coverage, or go to your nearest emergency room. There will always be professional coverage available through the message on the answering machine if I plan to be away.
REFERRALS I maintain a referral list of mental health professionals to whom I will make referrals when consultation or additional services are needed. These professionals have agreed to work closely with me and any referrals.
QUESTIONS/INFORMATION Please ask any questions you may have about your therapy process or the way in which I work. I view therapy as a joint process in which asking questions is a vital part of our learning how to work together.
Kathryn Harris, LCSW