Therapy 

It is the expectation that you will benefit from psychotherapy, but there is no guarantee. Therapy is conducted in-person in our office or online with interactive video or via telephone.

Confidentiality

The information you disclose during the course of therapy is confidential. However, there are legal exceptions for reporting, both mandatory and permissible when there is a threat of harm to self or others, or if ordered by a court through legal process.

Fees and Terms

My fee for a 55 minute for video or phone session for individuals, couples or families is shown below.

You will receive an invoice electronically when you schedule the session. The full fee must be paid at least 24 hours before the start of the scheduled session or it will be automatically cancelled. You may cancel the session with 24 hours prior notice and receive a full refund. No cancellations will be accepted within 24 hours of the scheduled time.

Art Therapy

Art therapy is one of the many methods of available treatment. If interested and it is clinically appropriate to integrate art therapy, the artwork created during sessions will fall under the guidelines of confidentiality.

By signing this form below I agree to the following:

1. I or one of my family members being counseled by The Therapist resides in the state California.
2. I understand that there are risks associated with participating in Telehealth including, but not limited to, the possibility, despite reasonable efforts and safeguards on the part of my therapist, that my psychotherapy sessions and transmission of my treatment information could be disrupted or distorted by technical failures and/or interrupted or accessed by unauthorized persons, and that the electronic storage of my treatment information could be accessed by unauthorized persons.
3. I have reviewed the legally-required “HIPAA Notice of Privacy” and "Good Faith Estimate" notices available online at loriconroy.com/forms.
4. (If you are 65 years old or older) By signing below I have reviewed and agree to the terms outlined on the "Self Pay (Opt Out) of Medical Services" form posted at loriconroy.com/forms.
5. If consenting to couples or family therapy I understand that there is no confidentiality between clients, and if I reveal information during counseling The Therapist they may disclose that information if they feel it is in the best interest of the family.
6. I agree that i am responsible for the payment of all Fees as agreed in discusion with The Therapist.   
7. I agree to participate in psychotherapy with The Therapist. I have read, understood and comply with the agreed upon policies.