PRACTICE POLICIES

AUTO-PAY

To ensure efficient payment management and to enhance client convenience, all clients must enroll in autopay by providing valid payment information in the form of a credit/debit card. Enrollment is mandatory before the first therapy session and can be completed through our secure online portal or via Alma. Upon processing, clients will receive an email notification confirming the autopay charge.

Autopay charges will be processed on a recurring basis, corresponding with the client's scheduled therapy sessions. This agreement remains in effect for the duration of the therapy services provided by our practice. If a transaction fails, clients will be notified immediately and are required to provide an alternative payment method within 48 hours.

TELEPHONE ACCESSIBILITY 

If you need to contact your therapist between sessions, please text or leave a voicemail. Your therapist may not be immediately available; however, they will attempt to return your call within 24 hours. If a true emergency situation arises, please call 911 or visit your local emergency department. 

SOCIAL MEDIA AND TELECOMMUNICATION 

Due to the importance of your confidentiality and the importance of minimizing dual relationships, clinicians of Sunstone Psychotherapy Mental Health Counseling PC do not accept friend or contact requests on personal accounts from current or former clients on any social networking site (Facebook, LinkedIn, etc). Adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of the therapeutic relationship. If you have questions about this, please bring them up during session. 

ELECTRONIC COMMUNICATION 

We 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, we will do so. While we may try to return messages in a timely manner, we cannot guarantee immediate response and request that you do not use these methods of communication to discuss therapeutic content.

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 New York. If you and your therapist choose 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, and 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, diagnoses, and interventions based not only on direct verbal or auditory communications, written reports, and third-person consultations but also on 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.

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 therapist may terminate treatment after an appropriate discussion with you and a termination process if it is determined that the psychotherapy is not effective, your therapist 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, we 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 or attend scheduled appointments for three consecutive weeks, unless other arrangements have been made in advance, for legal and ethical reasons, the practice must consider the professional relationship discontinued.

BY SIGNING BELOW, I AGREE THAT I HAVE READ, UNDERSTOOD, AND AGREE TO THE ITEMS CONTAINED IN THIS DOCUMENT.

General Information

The therapeutic relationship is unique in that it is a highly personal and at the same time, a contractual agreement. Given this, it is important for us to reach a clear understanding about how our relationship will work, and what each of us can expect. This consent will provide a clear framework for our work together. Feel free to discuss any of this with me. Please read and indicate that you have reviewed this information and agree to it by filling in the checkbox at the end of this document.

The Therapeutic Process
You have taken a very positive step by deciding to seek therapy. The outcome of your treatment depends largely on your willingness to engage in this process, which may, at times, result in considerable discomfort. Remembering unpleasant events and becoming aware of feelings attached to those events can bring on strong feelings of anger, depression, anxiety, etc. There are no miracle cures. I cannot promise that your behavior or circumstance will change. I can promise to support you and do my very best to understand you and repeating patterns, as well as to help you clarify what it is that you want for yourself.

Confidentiality
The session content and all relevant materials to the client's treatment will be held confidential unless the client requests in writing to have all or portions of such content released to a specifically named person/persons. Limitations of such client held privilege of confidentiality exist and are itemized below:

1. If a client threatens or attempts to commit suicide or otherwise conducts themselves in a manner in which there is a substantial risk of incurring serious bodily harm. 

2. If a client threatens grave bodily harm or death to another person.

3. If the therapist has a reasonable suspicion that a client or other named victim is the perpetrator, observer of, or actual victim of physical, emotional or sexual abuse of children under the age of 18 years.

4. Suspicions as stated above in the case of an elderly person who may be subjected to these abuses.

5. Suspected neglect of the parties named in items #3 and # 4.

6. If a court of law issues a legitimate subpoena for information stated on the subpoena.

7. If a client is in therapy or being treated by order of a court of law, or if information is obtained for the purpose of rendering an expert's report to an attorney.

Occasionally I may need to consult with other professionals in their areas of expertise in order to provide the best treatment for you. Information about you may be shared in this context without using your name.

If we see each other accidentally outside of the therapy office, I will not acknowledge you first. Your right to privacy and confidentiality is of the utmost importance to me, and I do not wish to jeopardize your privacy. However, if you acknowledge me first, I will be more than happy to speak briefly with you, but feel it appropriate not to engage in any lengthy discussions in public or outside of the therapy office.

BY SIGNING BELOW I AM AGREEING THAT I HAVE READ, UNDERSTOOD AND AGREE TO THE ITEMS CONTAINED IN THIS DOCUMENT.

I understand that my health care provider wishes me to engage in a telehealth consultation. My health care provider explained to me how the video conferencing technology that will be used to affect such a consultation will not be the same as a direct client/health care provider visit due to the fact that I will not be in the same room as my provider. I understand that a telehealth consultation has potential benefits including easier access to care and the convenience of meeting from a location of my choosing. I understand there are potential risks to this technology, including interruptions, unauthorized access, and technical difficulties. I understand that my health care provider or I can discontinue the telehealth consult/visit if it is felt that the videoconferencing connections are not adequate for the situation. I have had a direct conversation with my provider, during which I had the opportunity to ask questions in regard to this procedure. My questions have been answered and the risks, benefits, and practical alternatives have been discussed with me in a language that I understand.

CONSENT TO USE THE TELEHEALTH BY COUNSOL 

Telehealth by Counsol is the technology service we will use to conduct telehealth video conferencing appointments. If you wish to use another HIPAA-compliant alternative, please request one and every effort will be made to accomodate your needs. 

By signing this document, I acknowledge:

Telehealth is NOT an Emergency Service and in the event of an emergency, I will use a phone to call 911. Though my provider and I may be in direct, virtual contact through the Telehealth Service, neither Counsol nor the Telehealth Service provides any medical or healthcare services or advice including, but not limited to, emergency or urgent medical services. Telehealth by Counsol facilitates videoconferencing and is not responsible for the delivery of any healthcare, medical advice, or care. I do not assume that my provider has access to any or all of the technical information in the Telehealth by SimplePractice Service - or that such information is current, accurate, or up-to-date. I will not rely on my health care provider to have any of this information in the Telehealth by Counsol service. To maintain confidentiality, I will not share my telehealth appointment link with anyone unauthorized to attend the appointment.

By signing this form, I certify:

That I have read or had this form read and/or had this form explained to me.That I fully understand its contents including the risks and benefits of the procedure(s).That I have been given ample opportunity to ask questions and that any questions have been answered to my satisfaction.

BY SIGNING BELOW I AM AGREEING THAT I HAVE READ, UNDERSTOOD AND AGREE TO THE ITEMS CONTAINED IN THIS DOCUMENT.

Cancellation Policy

At Sunstone Psychotherapy Mental Health Counseling PC, we value the therapeutic process and strive to provide the best possible care to each of our clients. To maintain fairness and respect for both your time and the therapist's, we have outlined the following cancellation policy:

1. Cancellation with Notice:
We kindly request that clients provide at least 48 hours notice if they need to cancel or reschedule an appointment. This allows us to offer the time slot to other clients who may be in need of care. If a cancellation occurs with at least 48 hours notice, no charge will apply.

2. Rescheduling for the Same Week:
If you need to reschedule your appointment for another day during the same week and make the request within the 48-hour window, it will not be considered a late cancellation. This will allow flexibility for both you and the therapist.

3. Late Cancellations:
Cancellations made less than 48 hours before the appointment will be charged a late cancellation fee of $80. This fee compensates for the time that could have been allocated to another client.

4. No-Show Policy:
If a client does not attend a scheduled appointment without prior notice, the fee will be $150. This fee reflects the therapist's time and the inability to offer the appointment to another client.

5. Emergencies:
We understand that emergencies can arise unexpectedly. If you experience a one-time emergency and need to cancel without 48 hours' notice, it will not count as a late cancellation. Please inform us as soon as possible, and we will make accommodations accordingly.

6. Therapist Cancellation:
If the therapist must cancel an appointment within 48 hours of the scheduled time, you will be granted a one-time pass to cancel or reschedule without incurring a late cancellation fee. This policy is in place to ensure fairness when unforeseen circumstances arise on our end.

By scheduling an appointment, you agree to this cancellation policy. If you have any questions or need further clarification, please feel free to contact us.

Thank you for your understanding and cooperation. We look forward to working with you!