I/We hereby certify that I/We have received an orientation to Red Road Counseling Services, LLC. I have received orientation material and copies relating to my services and fully understand the material. My orientation included the following and was explained to me in a manner that I can understand:
Client Bill of Rights
Confidentiality of Client Records
Client Grievance Procedure
Therapeutic Model & Description of Treatment Modality and Services
HIPAA/Notice of Privacy Practice
Program Handbook
Fee Schedule and Financial Arrangements
Services Available
Treatment Goals/Objectives
Emergency Procedures
Availability of Crisis Intervention Services (including the telephone number where staff can always be reached)