You, the client, hereby give Marcia E. Brubeck, LCSW, permission to provide you with outpatient psychotherapy in accordance with a plan for individual therapy that she will discuss with you that may include sessions provided in the office, in the community, or via teletherapy. As a client, you understand that you have the right to be treated with respect and honesty. You can expect your treatment to reflect the highest professional and ethical standards for as long as you choose to continue the therapeutic relationship.
Outpatient psychotherapy does not carry significant risks. Regular sessions are necessary for maximum benefits. You understand that treatment is expected to be beneficial but that there are no guarantees and that during treatment you may feel temporarily worse.
During the term of our treatment, you may contact me by phone, text message, or email. I will respond as promptly as possible, generally within 24 hours during the work week (Monday - Thursday). I may take notes on our phone conversations. I have a secure fax, but I cannot ensure the confidentiality of voice, email, or text communications.
I maintain an internet presence in the form of a website, several Facebook pages, and profiles on other media sites. These sites publish professional information about me and items of possible interest to clients and consumers of my information products and services. You are free to friend me or sign up for information through these sites. I do not use the internet for research except in connection with your treatment goals (i.e., to locate resources).
1. Appointments start on the hour. If you arrive early, please wait in the waiting area.
2. Unless you alert me that you will be late for a session, I will not wait more than 20 minutes.
3. You are responsible for verifying that your insurance company recognizes me as an in-network provider and for obtaining any needed initial authorization or information regarding the number of sessions covered under your particular policy.
4. Payments or copayments are due at the time of the session. Feel free to use the Paypal button on the telemedicine page of my website.
5. If you don't appear for a scheduled session or if you cancel less than 24 hours beforehand, I will charge you the amount that I would have been reimbursed, whether by you or by your insurance company. This amount is payable before our next session unless my contract with your insurer specifies that I may not charge you for late cancellations or no-shows.