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WS New Client Intake Form 

WS New Client Intake Form 

Welcome!

HIPAA

Compliance

  • 1


    Welcome to Wellness Solutions!

     

    • Picture It, Then Proceed - Before you dive into the online form, we strongly suggest snapping a pic of your government-issued ID and both sides of your insurance card. You’ll need to upload these to complete the process. Don’t worry, we don’t need your credit card info until you book an appointment. 

     

    • Pro tips - To make life easier, use a device with a large screen to fill out the form. You will be asked to provide the name and contact information of the guarantor for your care, the subscriber for your insurance, and your emergency contact. Also, you will be asked to upload images of your current government issued photo ID, as well as, the front and back if your insurance card to complete the form. Having this information available will assist you complete the form. This form will take approximately 30 minutes to complete. The form is only available online. There is no paper version of this form. The form cannot be started and saved to complete at a later time. Please ensure you have the time to complete the form once you begin. To avoid potential data loss do not start the form and then leave the tab open to complete at a later time. 

     

    • Paperless, Organized, Frictionless Intake - Our online intake process is designed to be quick, easy, and private. For security reasons, you can’t start and save the form to finish later—it’s a one-shot deal. And yes, it’s only online—no paper forms here! 

     

    • Thoughtful & Thorough - We encourage you to fill out the form as honestly and thoroughly as you’re comfortable. Your privacy is our priority, and we’re here to help. We ask that you approach the online intake form thoughtfully so we can truly understand you in a meaningful way. Completing the form with care helps us help you better. If we don’t have the details we need, we might not be able to provide the support you seek. Skimming through and forcing the form might limit our ability to assist you.

     

    • Collaborate & Coordinate - Wellness Solutions will do our best to match your preferences for care. If we can’t, we will provide the available options so you can make the best informed decision for yourself. WS can’t guarantee an appointment or a specific clinician—new client appointments depend on clinical availability, expertise, and the client's schedule.

     

    • Understanding, Patience, & Quality Care - We only collect the information to provide quality personalized care and required by Federal law, Texas law, and insurance regulations. We cannot provide care to a client without collecting client information, insurance information, and the permissions and consents required. We understand that some clients may not be comfortable providing certain information and we respect your rights and your comfort. Please complete the forms as much as your are comfortable and feel emotionally safe. We honor your right to exercise discernment with your personal information. We will make decisions regarding a client's admission to care based on the information provided. 

     

    • Encouragement & Celebration Stickers - We included encouragement and celebration stickers throughout the intake form to help provide support and positive vibes as you complete the intake process. We aim to make your care journey with Wellness Solutions positive. We also include emails to support your new client onboarding to provide valuable information and empower your experience.  

     

     

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  • 2
    Our new client intake journey is designed for your convenience and satisfaction. We guide you through each step with compassion, understanding, and support.
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  • 3
    Our client care journey supports you while you focus on achieving your goals. We encourage and inspire our client community to normalize seeking support, guidance, and care throughout the inevitable changes that challenge us in our lives.
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  • 4
    To obtain an appointment you must reply with YES. If you reply to this question with NO then we will not be able to provide an appointment as this is a formal acknowlegement of our policies and procedures.
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  • 5
    To obtain an appointment you must reply with YES. If you reply to this question with NO then we will not be able to provide an appointment as this is a formal acknowlegement of our policies and procedures.
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  • 6
    To obtain an appointment you must reply with YES. If you reply to this question with NO then we will not be able to provide an appointment as this is a formal acknowlegement of our policies and procedures.
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  • 7
    To obtain an appointment you must reply with YES. If you reply to this question with NO then we will not be able to provide an appointment as this is a formal acknowlegement of our policies and procedures.
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  • 8
    To obtain an appointment you must reply with YES. If you reply to this question with NO then we will not be able to provide an appointment as this is a formal acknowlegement of our policies and procedures.
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  • 9
    To obtain an appointment you must reply with YES. If you reply to this question with NO then we will not be able to provide an appointment as this is a formal acknowlegement of our policies and procedures.
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  • 10
    To obtain an appointment you must reply with YES. If you reply to this question with NO then we will not be able to provide an appointment as this is a formal acknowlegement of our policies and procedures.
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  • 11
    To obtain an appointment you must reply with YES. If you reply to this question with NO then we will not be able to provide an appointment as this is a formal acknowlegement of our policies and procedures.
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  • 12
    To obtain an appointment you must reply with YES. If you reply to this question with NO then we will not be able to provide an appointment as this is a formal acknowlegement of our policies and procedures.
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  • 13
    To obtain an appointment you must reply with YES. If you reply to this question with NO then we will not be able to provide an appointment as this is a formal acknowlegement of our policies and procedures.
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  • 14

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  • 15

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  • 16
    Please provide your first and last name.
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  • 17
    Please provide your chosen name or nick name.
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  • 18
    Please provide any previous names you have used.
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  • 19
    Please provide your cell phone number. This number should be private to allow for scheduling and confidential communications via phone, text, and VM. PLEASE BE CAREFUL WITH FORMATTING!
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  • 20
    To complete the form you will be required to acknowledge and agree to the above policy. Please answer "yes" and agree with the information or permissions noted, otherwise the form will not permit you to continue with registration and all form fields will be locked.
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  • 21
    Please provide your email address. This email should be private to allow for confidential communications. This email will be used to send links to your client appointments. PLEASE BE CAREFUL WITH FORMATTING!
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  • 22
    To complete the form you will be required to acknowledge and agree to the above policy. Please answer "yes" and agree with the information or permissions noted, otherwise the form will not permit you to continue with registration and all form fields will be locked.
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  • 23
    Please enter your date of birth in the following format XX/XX/XXXX. Wellness Solutions provides services to clients who are 18 years of age and older.
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  • 24
    Please enter your current age. Wellness Solutions provides services to clients who are 18 years of age and older.
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  • 25
    Please provide your primary address below.
    Please Select
    • Please Select
    • Afghanistan
    • Albania
    • Algeria
    • American Samoa
    • Andorra
    • Angola
    • Anguilla
    • Antigua and Barbuda
    • Argentina
    • Armenia
    • Aruba
    • Australia
    • Austria
    • Azerbaijan
    • The Bahamas
    • Bahrain
    • Bangladesh
    • Barbados
    • Belarus
    • Belgium
    • Belize
    • Benin
    • Bermuda
    • Bhutan
    • Bolivia
    • Bosnia and Herzegovina
    • Botswana
    • Brazil
    • Brunei
    • Bulgaria
    • Burkina Faso
    • Burundi
    • Cambodia
    • Cameroon
    • Canada
    • Cape Verde
    • Cayman Islands
    • Central African Republic
    • Chad
    • Chile
    • China
    • Christmas Island
    • Cocos (Keeling) Islands
    • Colombia
    • Comoros
    • Congo
    • Cook Islands
    • Costa Rica
    • Cote d'Ivoire
    • Croatia
    • Cuba
    • Curaçao
    • Cyprus
    • Czech Republic
    • Democratic Republic of the Congo
    • Denmark
    • Djibouti
    • Dominica
    • Dominican Republic
    • Ecuador
    • Egypt
    • El Salvador
    • Equatorial Guinea
    • Eritrea
    • Estonia
    • Ethiopia
    • Falkland Islands
    • Faroe Islands
    • Fiji
    • Finland
    • France
    • French Polynesia
    • Gabon
    • The Gambia
    • Georgia
    • Germany
    • Ghana
    • Gibraltar
    • Greece
    • Greenland
    • Grenada
    • Guadeloupe
    • Guam
    • Guatemala
    • Guernsey
    • Guinea
    • Guinea-Bissau
    • Guyana
    • Haiti
    • Honduras
    • Hong Kong
    • Hungary
    • Iceland
    • India
    • Indonesia
    • Iran
    • Iraq
    • Ireland
    • Israel
    • Italy
    • Jamaica
    • Japan
    • Jersey
    • Jordan
    • Kazakhstan
    • Kenya
    • Kiribati
    • North Korea
    • South Korea
    • Kosovo
    • Kuwait
    • Kyrgyzstan
    • Laos
    • Latvia
    • Lebanon
    • Lesotho
    • Liberia
    • Libya
    • Liechtenstein
    • Lithuania
    • Luxembourg
    • Macau
    • Macedonia
    • Madagascar
    • Malawi
    • Malaysia
    • Maldives
    • Mali
    • Malta
    • Marshall Islands
    • Martinique
    • Mauritania
    • Mauritius
    • Mayotte
    • Mexico
    • Micronesia
    • Moldova
    • Monaco
    • Mongolia
    • Montenegro
    • Montserrat
    • Morocco
    • Mozambique
    • Myanmar
    • Nagorno-Karabakh
    • Namibia
    • Nauru
    • Nepal
    • Netherlands
    • Netherlands Antilles
    • New Caledonia
    • New Zealand
    • Nicaragua
    • Niger
    • Nigeria
    • Niue
    • Norfolk Island
    • Turkish Republic of Northern Cyprus
    • Northern Mariana
    • Norway
    • Oman
    • Pakistan
    • Palau
    • Palestine
    • Panama
    • Papua New Guinea
    • Paraguay
    • Peru
    • Philippines
    • Pitcairn Islands
    • Poland
    • Portugal
    • Puerto Rico
    • Qatar
    • Republic of the Congo
    • Romania
    • Russia
    • Rwanda
    • Saint Barthelemy
    • Saint Helena
    • Saint Kitts and Nevis
    • Saint Lucia
    • Saint Martin
    • Saint Pierre and Miquelon
    • Saint Vincent and the Grenadines
    • Samoa
    • San Marino
    • Sao Tome and Principe
    • Saudi Arabia
    • Senegal
    • Serbia
    • Seychelles
    • Sierra Leone
    • Singapore
    • Slovakia
    • Slovenia
    • Solomon Islands
    • Somalia
    • Somaliland
    • South Africa
    • South Ossetia
    • South Sudan
    • Spain
    • Sri Lanka
    • Sudan
    • Suriname
    • Svalbard
    • eSwatini
    • Sweden
    • Switzerland
    • Syria
    • Taiwan
    • Tajikistan
    • Tanzania
    • Thailand
    • Timor-Leste
    • Togo
    • Tokelau
    • Tonga
    • Transnistria Pridnestrovie
    • Trinidad and Tobago
    • Tristan da Cunha
    • Tunisia
    • Turkey
    • Turkmenistan
    • Turks and Caicos Islands
    • Tuvalu
    • Uganda
    • Ukraine
    • United Arab Emirates
    • United Kingdom
    • United States
    • Uruguay
    • Uzbekistan
    • Vanuatu
    • Vatican City
    • Venezuela
    • Vietnam
    • British Virgin Islands
    • Isle of Man
    • US Virgin Islands
    • Wallis and Futuna
    • Western Sahara
    • Yemen
    • Zambia
    • Zimbabwe
    • Other
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  • 26
    Please provide your temporary address below. This address is for clients who have more than one living address, for example: Clients who are in university and do not live at home, for clients who have two separate addresses for their parents, or may be splitting their time between more than once residence.
    Please Select
    • Please Select
    • Afghanistan
    • Albania
    • Algeria
    • American Samoa
    • Andorra
    • Angola
    • Anguilla
    • Antigua and Barbuda
    • Argentina
    • Armenia
    • Aruba
    • Australia
    • Austria
    • Azerbaijan
    • The Bahamas
    • Bahrain
    • Bangladesh
    • Barbados
    • Belarus
    • Belgium
    • Belize
    • Benin
    • Bermuda
    • Bhutan
    • Bolivia
    • Bosnia and Herzegovina
    • Botswana
    • Brazil
    • Brunei
    • Bulgaria
    • Burkina Faso
    • Burundi
    • Cambodia
    • Cameroon
    • Canada
    • Cape Verde
    • Cayman Islands
    • Central African Republic
    • Chad
    • Chile
    • China
    • Christmas Island
    • Cocos (Keeling) Islands
    • Colombia
    • Comoros
    • Congo
    • Cook Islands
    • Costa Rica
    • Cote d'Ivoire
    • Croatia
    • Cuba
    • Curaçao
    • Cyprus
    • Czech Republic
    • Democratic Republic of the Congo
    • Denmark
    • Djibouti
    • Dominica
    • Dominican Republic
    • Ecuador
    • Egypt
    • El Salvador
    • Equatorial Guinea
    • Eritrea
    • Estonia
    • Ethiopia
    • Falkland Islands
    • Faroe Islands
    • Fiji
    • Finland
    • France
    • French Polynesia
    • Gabon
    • The Gambia
    • Georgia
    • Germany
    • Ghana
    • Gibraltar
    • Greece
    • Greenland
    • Grenada
    • Guadeloupe
    • Guam
    • Guatemala
    • Guernsey
    • Guinea
    • Guinea-Bissau
    • Guyana
    • Haiti
    • Honduras
    • Hong Kong
    • Hungary
    • Iceland
    • India
    • Indonesia
    • Iran
    • Iraq
    • Ireland
    • Israel
    • Italy
    • Jamaica
    • Japan
    • Jersey
    • Jordan
    • Kazakhstan
    • Kenya
    • Kiribati
    • North Korea
    • South Korea
    • Kosovo
    • Kuwait
    • Kyrgyzstan
    • Laos
    • Latvia
    • Lebanon
    • Lesotho
    • Liberia
    • Libya
    • Liechtenstein
    • Lithuania
    • Luxembourg
    • Macau
    • Macedonia
    • Madagascar
    • Malawi
    • Malaysia
    • Maldives
    • Mali
    • Malta
    • Marshall Islands
    • Martinique
    • Mauritania
    • Mauritius
    • Mayotte
    • Mexico
    • Micronesia
    • Moldova
    • Monaco
    • Mongolia
    • Montenegro
    • Montserrat
    • Morocco
    • Mozambique
    • Myanmar
    • Nagorno-Karabakh
    • Namibia
    • Nauru
    • Nepal
    • Netherlands
    • Netherlands Antilles
    • New Caledonia
    • New Zealand
    • Nicaragua
    • Niger
    • Nigeria
    • Niue
    • Norfolk Island
    • Turkish Republic of Northern Cyprus
    • Northern Mariana
    • Norway
    • Oman
    • Pakistan
    • Palau
    • Palestine
    • Panama
    • Papua New Guinea
    • Paraguay
    • Peru
    • Philippines
    • Pitcairn Islands
    • Poland
    • Portugal
    • Puerto Rico
    • Qatar
    • Republic of the Congo
    • Romania
    • Russia
    • Rwanda
    • Saint Barthelemy
    • Saint Helena
    • Saint Kitts and Nevis
    • Saint Lucia
    • Saint Martin
    • Saint Pierre and Miquelon
    • Saint Vincent and the Grenadines
    • Samoa
    • San Marino
    • Sao Tome and Principe
    • Saudi Arabia
    • Senegal
    • Serbia
    • Seychelles
    • Sierra Leone
    • Singapore
    • Slovakia
    • Slovenia
    • Solomon Islands
    • Somalia
    • Somaliland
    • South Africa
    • South Ossetia
    • South Sudan
    • Spain
    • Sri Lanka
    • Sudan
    • Suriname
    • Svalbard
    • eSwatini
    • Sweden
    • Switzerland
    • Syria
    • Taiwan
    • Tajikistan
    • Tanzania
    • Thailand
    • Timor-Leste
    • Togo
    • Tokelau
    • Tonga
    • Transnistria Pridnestrovie
    • Trinidad and Tobago
    • Tristan da Cunha
    • Tunisia
    • Turkey
    • Turkmenistan
    • Turks and Caicos Islands
    • Tuvalu
    • Uganda
    • Ukraine
    • United Arab Emirates
    • United Kingdom
    • United States
    • Uruguay
    • Uzbekistan
    • Vanuatu
    • Vatican City
    • Venezuela
    • Vietnam
    • British Virgin Islands
    • Isle of Man
    • US Virgin Islands
    • Wallis and Futuna
    • Western Sahara
    • Yemen
    • Zambia
    • Zimbabwe
    • Other
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  • 27
    This information is required for appropriate identity verification.
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  • 28
    Please choose from the drop down menu.
    • New Client
    • Readmitting Client (It has been 2 months or more since your last appointment.)
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  • 29
    Please choose from the drop down menu.
    • Individual Counseling & Psychotherapy
    • EMDR Individual Counseling & Psychotherapy
    • EMDR Bundle
    • Coaching
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  • 30
    Please click on ALL appointment spots convenient to your schedule for consistent weekly appointments. The more availability you are able to provide the more likely we are to provide an appointment.
    1 of 10
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  • 31
    Please provide your answer in the space provided.
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  • 32
    Please provide the first and last name of the client's emergency contact.
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  • 33
    Please provide the cell phone number of the client's emergency contact.
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  • 34
    Please provide the email of the client's emergency contact.
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  • 35
    Please describe the emergency contract's relationship to the client.
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  • 36
    To complete the form you will be required to acknowledge and agree to the above policy. Please answer "yes" and agree with the information or permissions noted, otherwise the form will not permit you to continue with registration and all form fields will be locked.
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  • 37

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  • 38

     

    • Save Time, Money, & Frustration! Make sure you provide CORRECT client registration, demographics, and insurance information. 

      

    • PLEASE make sure that the information you provide for client registration including insurance and demographics are correct. This will help avoid rejected and denied claims and avoid unnecessary fees. 

     

    • PLEASE make sure that you check your insurance benefits with your insurance company and are familiar with your policy benefits. 

     

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  • 39
    Guarantor - The individual responsible for his/her financial responsibilities for treatment services. If the client is a minor than usually one of the client's parents is the guarantor. If the client is an adult then usually the client is the guarantor. Please select the correct option from the drop-down options below.
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  • 40
    Please enter the first and last name of the client's guarantor.
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  • 41
    Please enter the phone number of the client's guarantor.
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  • 42
    Please enter the email of the client's guarantor.
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  • 43
    Please enter the address of the client's guarantor below.
    Please Select
    • Please Select
    • Afghanistan
    • Albania
    • Algeria
    • American Samoa
    • Andorra
    • Angola
    • Anguilla
    • Antigua and Barbuda
    • Argentina
    • Armenia
    • Aruba
    • Australia
    • Austria
    • Azerbaijan
    • The Bahamas
    • Bahrain
    • Bangladesh
    • Barbados
    • Belarus
    • Belgium
    • Belize
    • Benin
    • Bermuda
    • Bhutan
    • Bolivia
    • Bosnia and Herzegovina
    • Botswana
    • Brazil
    • Brunei
    • Bulgaria
    • Burkina Faso
    • Burundi
    • Cambodia
    • Cameroon
    • Canada
    • Cape Verde
    • Cayman Islands
    • Central African Republic
    • Chad
    • Chile
    • China
    • Christmas Island
    • Cocos (Keeling) Islands
    • Colombia
    • Comoros
    • Congo
    • Cook Islands
    • Costa Rica
    • Cote d'Ivoire
    • Croatia
    • Cuba
    • Curaçao
    • Cyprus
    • Czech Republic
    • Democratic Republic of the Congo
    • Denmark
    • Djibouti
    • Dominica
    • Dominican Republic
    • Ecuador
    • Egypt
    • El Salvador
    • Equatorial Guinea
    • Eritrea
    • Estonia
    • Ethiopia
    • Falkland Islands
    • Faroe Islands
    • Fiji
    • Finland
    • France
    • French Polynesia
    • Gabon
    • The Gambia
    • Georgia
    • Germany
    • Ghana
    • Gibraltar
    • Greece
    • Greenland
    • Grenada
    • Guadeloupe
    • Guam
    • Guatemala
    • Guernsey
    • Guinea
    • Guinea-Bissau
    • Guyana
    • Haiti
    • Honduras
    • Hong Kong
    • Hungary
    • Iceland
    • India
    • Indonesia
    • Iran
    • Iraq
    • Ireland
    • Israel
    • Italy
    • Jamaica
    • Japan
    • Jersey
    • Jordan
    • Kazakhstan
    • Kenya
    • Kiribati
    • North Korea
    • South Korea
    • Kosovo
    • Kuwait
    • Kyrgyzstan
    • Laos
    • Latvia
    • Lebanon
    • Lesotho
    • Liberia
    • Libya
    • Liechtenstein
    • Lithuania
    • Luxembourg
    • Macau
    • Macedonia
    • Madagascar
    • Malawi
    • Malaysia
    • Maldives
    • Mali
    • Malta
    • Marshall Islands
    • Martinique
    • Mauritania
    • Mauritius
    • Mayotte
    • Mexico
    • Micronesia
    • Moldova
    • Monaco
    • Mongolia
    • Montenegro
    • Montserrat
    • Morocco
    • Mozambique
    • Myanmar
    • Nagorno-Karabakh
    • Namibia
    • Nauru
    • Nepal
    • Netherlands
    • Netherlands Antilles
    • New Caledonia
    • New Zealand
    • Nicaragua
    • Niger
    • Nigeria
    • Niue
    • Norfolk Island
    • Turkish Republic of Northern Cyprus
    • Northern Mariana
    • Norway
    • Oman
    • Pakistan
    • Palau
    • Palestine
    • Panama
    • Papua New Guinea
    • Paraguay
    • Peru
    • Philippines
    • Pitcairn Islands
    • Poland
    • Portugal
    • Puerto Rico
    • Qatar
    • Republic of the Congo
    • Romania
    • Russia
    • Rwanda
    • Saint Barthelemy
    • Saint Helena
    • Saint Kitts and Nevis
    • Saint Lucia
    • Saint Martin
    • Saint Pierre and Miquelon
    • Saint Vincent and the Grenadines
    • Samoa
    • San Marino
    • Sao Tome and Principe
    • Saudi Arabia
    • Senegal
    • Serbia
    • Seychelles
    • Sierra Leone
    • Singapore
    • Slovakia
    • Slovenia
    • Solomon Islands
    • Somalia
    • Somaliland
    • South Africa
    • South Ossetia
    • South Sudan
    • Spain
    • Sri Lanka
    • Sudan
    • Suriname
    • Svalbard
    • eSwatini
    • Sweden
    • Switzerland
    • Syria
    • Taiwan
    • Tajikistan
    • Tanzania
    • Thailand
    • Timor-Leste
    • Togo
    • Tokelau
    • Tonga
    • Transnistria Pridnestrovie
    • Trinidad and Tobago
    • Tristan da Cunha
    • Tunisia
    • Turkey
    • Turkmenistan
    • Turks and Caicos Islands
    • Tuvalu
    • Uganda
    • Ukraine
    • United Arab Emirates
    • United Kingdom
    • United States
    • Uruguay
    • Uzbekistan
    • Vanuatu
    • Vatican City
    • Venezuela
    • Vietnam
    • British Virgin Islands
    • Isle of Man
    • US Virgin Islands
    • Wallis and Futuna
    • Western Sahara
    • Yemen
    • Zambia
    • Zimbabwe
    • Other
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  • 44

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  • 45
    To complete the form you will be required to acknowledge and agree to the above policy. Please answer "yes" and agree with the information or permissions noted, otherwise the form will not permit you to continue with registration and all form fields will be locked.
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  • 46
    To complete the form you will be required to acknowledge and agree to the above policy. Please answer "yes" and agree with the information or permissions noted, otherwise the form will not permit you to continue with registration and all form fields will be locked.
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  • 47
    To complete the form you will be required to acknowledge and agree to the above policy. Please answer "yes" and agree with the information or permissions noted, otherwise the form will not permit you to continue with registration and all form fields will be locked.
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  • 48
    Please choose the correct answer.
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  • 49
    Please select the correct answer.
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  • 50

    PLEASE READ THIS IMPORTANT INFORMATION!!!

     

    Ths information is for clients who have TWO Private Commercial Insurance Policies.

     

    You are seeing this message becasue you indicated that you have TWO Private Commercial Insurance Policies. 

     

    • For clients who have both primary and secondary private insurance, the insurance companies have rules to determine which insurance is considered primary and which insurance is considered secondary. 

     

    • Below you will find the rules private insurance companies use to determine which insurance is considered primary and which is considered secondary.

     

    • Since you indicated that you have two insurance, please review the rules below to determine which of your insurance policies Wellness Solutions should use to help you pay for your services. 

     

    • Please note that if you have one public insurance policy, such as, Medicaid, and you have one private insurance policy, such as a Cigna commercial policy, then the private commercial policy is always primary. 

     

    How to Determine Which of Your Two Insurances is Primary: 

     

    • The Birthday Rule is a guideline used by insurance companies to determine the primary and secondary insurance coverage for a dependent when the client has two insurance plans. 

     

    • Primary Insurance: The insurance policy of the parent whose birthday (month and day, not year) comes first in the calendar year is considered the primary insurance. This means that the insurance plan of the parent with the earlier birthday will pay first.

     

    • Secondary Insurance: The insurance policy of the parent whose birthday falls later in the year becomes the secondary insurance. This plan covers costs that the primary insurance does not cover, subject to its own terms and conditions.

     

    • Example: If one parent’s birthday is on March 10th and the other’s is on July 25th, the insurance policy of the parent with the March 10th birthday would be the primary insurance, and the policy of the parent with the July 25th birthday would be secondary.

     

    Important Notes:

     

    • Year of Birth: The year of birth is not considered—only the month and day.
      Exceptions: If the parents are divorced or separated, the custody agreement or court order may determine which insurance is primary. Additionally, some states or insurance plans may have different rules.

     

    • SUPER IMPORTANT: Wellness Solutions only bills primary insurance. Wellness Solutions does not bill secondary insurance. Please use the abive information to determine which of the two insurance policies you will use for your services. You cannot just pick one insurance based on preference. Any services denied by insurance will be the responsibility of the client to cover. If you provide the incorrect insurance policy then the services may be denied and the client will be responsible for all denied charges. 
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    Sliding Scale Fees are discounted to assist clients who do not have insurance and would find regular fees cost prohibitive for receiving care. Sliding scale fees reduce some fees for services though they do not apply to all services.
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    Please enter the name of the insurance company. For example, BCBS, Cigna, or United HealthCare.
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    Please enter the insurance member identification number. Please include ALL letters and numbers.
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    Please enter the insurance group number. Please include ALL letters and numbers.
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    Subscriber: An insurance subscriber is the person who signs up for and pays for an insurance policy. This person is also responsible for making decisions about the policy, like choosing what kind of coverage to get. This is the person who you get your insurance from. If your insurance is through a partner or parent then they are the subscriber.
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    Please enter the first and last name of the subscriber.
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    Please enter the subscriber's cell phone number.
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    Please enter the subscriber's address.
    Please Select
    • Please Select
    • Afghanistan
    • Albania
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    • American Samoa
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    • British Virgin Islands
    • Isle of Man
    • US Virgin Islands
    • Wallis and Futuna
    • Western Sahara
    • Yemen
    • Zambia
    • Zimbabwe
    • Other
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    If YES, you will be prompted to provide your EAP authorization number. The client is responsible for calling his or her insurance company to obtain the EAP authorization number. WS cannot obtain the EAP authorization number or number of approved sessions for the client. This must be completed by the client prior to initiating care. Once the client is scheduled for their first appointment WS will not change the client's payer source to an EAP provider. Also, please be aware that a client may only use their EAP benefits once. EAP benefits can only be used once per treatment episode.
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    To complete the form you will be required to acknowledge and agree to the above policy. Please answer "yes" and agree with the information or permissions noted, otherwise the form will not permit you to continue with registration and all form fields will be locked.
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    Please enter the EAP Authorization Number. Clients who use EAP benefits may only use them once. If you would like to use EAP benefits you are required to provide the authorization number. Once a client begins care they cannot use EAP benefits.
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    Please enter the EAP Number of Approved Sessions. Clients who use EAP benefits may only use them once. If you would like to use EAP benefits you are required to provide the number of sessions covered below. Once a client begins care they cannot use EAP benefits.
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    Please take a picture of the front and back of your insurance card and then upload the pictures/images of the insurance card.
    Drag and drop files here
    Select files to upload
    Max. file size: 10.6MB
    Cancelof
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    To complete the form you will be required to acknowledge and agree to the above policy. Please answer "yes" and agree with the information or permissions noted, otherwise the form will not permit you to continue with registration and all form fields will be locked.
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    To complete the form you will be required to acknowledge and agree to the above policy. Please answer "yes" and agree with the information or permissions noted, otherwise the form will not permit you to continue with registration and all form fields will be locked.
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    • Oops! You are receiving this message because of your response to the previous question.

     

    • Based on your "No" response to the new client getting started questions you cannot proceed with client registration.

     

    • If you would like to proceed then please click the "Previous" button below and select "Yes" to the new client getting started question.
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    Please select ALL that apply.
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    Please provide your answer in the space provided. Your reply is limited to 250 characters.
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    Please provide your answer in the space provided. Your reply is limited to 250 characters.
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    Please provide your answer in the space provided. Your reply is limited to 250 characters.
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    Please provide any information below that you would like to share that is relevant to your current symptoms and may influence your care. You may skip this question if you do not have anything to report or would prefer not to answer. Your reply is limited to 250 characters.
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    Please provide any information below that you would like to share that is relevant to your current symptoms and may influence your care. You may skip this question if you do not have anything to report or would prefer not to answer. Your reply is limited to 250 characters.
    0/250
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    Please provide any information below that you would like to share that is relevant to your current symptoms and may influence your care. You may skip this question if you do not have anything to report or would prefer not to answer. Your reply is limited to 250 characters.
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    Please provide any information below that you would like to share that is relevant to your current symptoms and may influence your care. You may skip this question if you do not have anything to report or would prefer not to answer. Your reply is limited to 250 characters.
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    Please provide any information below that you would like to share that is relevant to your current symptoms and may influence your care. You may skip this question if you do not have anything to report or would prefer not to answer. Your reply is limited to 250 characters.
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    Please provide any information below that you would like to share that is relevant to your current symptoms and may influence your care. You may skip this question if you do not have anything to report or would prefer not to answer. Your reply is limited to 250 characters.
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    Please provide any information below that you would like to share that is relevant to your current symptoms and may influence your care. You may skip this question if you do not have anything to report or would prefer not to answer. Your reply is limited to 250 characters.
    0/250
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    Please provide any information below that you would like to share that is relevant to your current symptoms and may influence your care. You may skip this question if you do not have anything to report or would prefer not to answer. Your reply is limited to 250 characters.
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    Please provide any information below that you would like to share that is relevant to your current symptoms and may influence your care. You may skip this question if you do not have anything to report or would prefer not to answer. Your reply is limited to 250 characters.
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    Please provide any information below that you would like to share that is relevant to your current symptoms and may influence your care. You may skip this question if you do not have anything to report or would prefer not to answer. Your reply is limited to 250 characters.
    0/250
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    Please provide any information below that you would like to share that is relevant to your current symptoms and may influence your care. You may skip this question if you do not have anything to report or would prefer not to answer. Your reply is limited to 250 characters.
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    What leisure, hobbies, and recreational activities do you enjoy? How often do you engage in your leisure, hobbies, and recreational activities? Please provide any information below that you would like to share that is relevant to your current symptoms and may influence your care. You may skip this question if you do not have anything to report or would prefer not to answer. Your reply is limited to 250 characters.
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    Please select all that apply.
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    Please provide any information below that you would like to share that is relevant to your current symptoms and may influence your care. You may skip this question if you do not have anything to report or would prefer not to answer. Your reply is limited to 250 characters.
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    Please provide any information below that you would like to share that is relevant to your current symptoms and may influence your care. You may skip this question if you do not have anything to report or would prefer not to answer. Your reply is limited to 250 characters.
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    Please provide any information below that you would like to share that is relevant to your current symptoms and may influence your care. You may skip this question if you do not have anything to report or would prefer not to answer. Your reply is limited to 250 characters.
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    Please provide any information below that you would like to share that is relevant to your current symptoms and may influence your care. You may skip this question if you do not have anything to report or would prefer not to answer. Your reply is limited to 250 characters.
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    Please provide any information below that you would like to share that is relevant to your current symptoms and may influence your care. You may skip this question if you do not have anything to report or would prefer not to answer. Your reply is limited to 250 characters.
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    Please provide any information below that you would like to share that is relevant to your current symptoms and may influence your care. You may skip this question if you do not have anything to report or would prefer not to answer. Your reply is limited to 250 characters.
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    Please provide any information below that you would like to share that is relevant to your current symptoms and may influence your care. You may skip this question if you do not have anything to report or would prefer not to answer. Your reply is limited to 250 characters.
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    Instructions: The questions below ask about things that might have bothered you. For each question, select the circle with the number that best describes how much (or how often) you have been bothered by each problem during the past TWO (2) WEEKS. This is a general symptom identification tool and is not going to provide a specific diagnosis.
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    The questions below ask about things that might have bothered you. For each question, circle the number that best describes how much (or how often) you have been bothered by each problem during the past 7 SEVEN DAYS. This is a general symptom identification tool and is not going to provide a specific diagnosis.
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    Please answer the below questions based on your feelings in the past 7 days. The following is the scoring range: 1. Never 2. Rarely 3. Sometimes 4. Often 5. Always
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    Please answer all questions. One answer is required for each question. READ THE QUESTIONS CAREFULLY. IT IS VERY IMPORTANT THAT WE UNDERSTAND ANY RISKS AND THAT THOSE RISKS CAN BE MANAGED TOGETHER IN A POSITIVE AND COLLABORATIVE MANNER.
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    Notice of Privacy Practices (NOPP)


    This Notice of Privacy Practices explains how we at Wellness Solutions, LLC may use and disclose your Protected Health Information (PHI) for treatment, payment, and healthcare operations, as well as for other purposes allowed or required by law. It also outlines your rights regarding your PHI. PHI includes information that can identify you, such as your name and health details, and relates to your past, present, or future physical or mental health or condition.

    1. How We May Use and Disclose Your PHI

    • As required by law, we may use and disclose your PHI when required by federal, state, or local law.
    • Legal Proceedings - We may disclose your PHI during legal proceedings, such as in response to a court order, subpoena, or other legal processes.
    • Accounting of Disclosures - You can request a list (accounting) of certain disclosures we’ve made of your PHI over the last six years. This list will not include disclosures made for treatment, payment, healthcare operations, or other exceptions as allowed by law. You are entitled to one free accounting every 12 months. Additional requests within the same year may incur a reasonable, cost-based fee.
    • Treatment - We may use or share your PHI to provide, coordinate, or manage your healthcare and related services. This includes sharing your information with third parties involved in your care, such as other healthcare providers or insurance companies.
    • Payment - Your PHI will be used as needed to obtain payment for your healthcare services. For instance, we may share relevant information with your health plan to get approval for treatment or payment.
    • Healthcare Operations - We may use or disclose your PHI to support the business activities of Wellness Solutions, LLC. These activities include quality assessments, employee training, licensing, and other business-related functions.
    • Emergencies - In emergency situations, we may use or disclose your PHI without your prior consent. We will try to get your consent as soon as reasonably possible after the emergency.
    • Request Confidential Communications - You can ask us to communicate with you in a particular way or at a certain location (for example, only contacting you by mail). We will accommodate reasonable requests.
    • Others Involved in Your Care - Unless you object, we may share your PHI with family members, friends, or others involved in your care. If you are unable to agree or object, we will use our best judgment to decide what is in your best interest.
    • Social Services, Fundraising, and Community Activities - We may use your PHI to contact you about social services, fundraising efforts, and community events. If you prefer not to be contacted for these purposes, you can opt out by calling us at (713) 893-3989 or emailing Admin@wellnesssolutionsllc.com.

     

    2. Special Situations

    • Public Health - We may disclose your PHI to public health authorities for purposes such as controlling disease, injury, or disability.
    • Communicable Diseases - We may share your PHI with individuals who may have been exposed to a communicable disease or are otherwise at risk, as allowed by law.
    • Health Oversight - We may disclose your PHI to health oversight agencies for activities like audits, investigations, and inspections.
    • Abuse or Neglect - We may disclose your PHI to authorized authorities if we believe you have been a victim of abuse, neglect, or domestic violence, as required by law.
    • Food and Drug Administration (FDA) - We may disclose your PHI to the FDA for purposes related to product safety and regulation.
    • Coroners, Funeral Directors, and Organ Donation - We may disclose your PHI to coroners, medical examiners, funeral directors, and organizations involved in organ donation.
    • Research - Your PHI may be used for research purposes if the research meets certain privacy safeguards and has been approved by an Institutional Review Board (IRB).
    • Criminal Activity - We may disclose your PHI to prevent or lessen a serious threat to health or safety, in accordance with applicable laws.
    • Military and National Security - We may disclose your PHI for military activities, national security, or to the Department of Veterans Affairs, as required by law.
    • Workers’ Compensation - Your PHI may be disclosed as necessary to comply with workers’ compensation laws.
    • Inmates - If you are an inmate, we may disclose your PHI to your correctional facility to provide healthcare or for the safety and security of the institution.

     

    3. Your Rights Regarding Your PHI

    • Copy of This Notice - You can request a paper copy of this notice at any time, even if you have agreed to receive it electronically. We will promptly provide you with a paper copy. You can also find a copy on our website: http://www.wellnesssolutionsllc.com
    • Amendment - You have the right to request that we amend your PHI if you believe it is incorrect or incomplete. Your request must be in writing and must state the reason for the amendment. We may deny your request if we believe the current information is accurate and complete or if the information was not created by us. If your request is denied, you have the right to file a statement of disagreement.

     

    4. Wellness Solutions, LLC Responsibilities

    • We are required by law to maintain the privacy and security of your PHI.
    • We will notify you promptly if a breach occurs that may compromise the privacy or security of your information.
    • We must follow the terms of this notice and provide you with a copy upon request.
    • We will not use or share your information other than as described here unless you provide written permission. If you give us permission, you may change your mind at any time by letting us know in writing.
    • We reserve the right to change the terms of this notice. Any changes will apply to all PHI we have about you, and the new notice will be available upon request, in our office, and on our website.

     

    5. Questions, Concerns, or Complaints

    If you believe your privacy rights have been violated, you can contact our Corporate Privacy Officer:

    Wellness Solutions, LLC  

    Attention: Danielle C. Ellis MA, MCJ, LPC, NCC

    Phone: (713) 893-3989 (Monday-Friday 9 AM - 5 PM CST)  

    Email: Admin@wellnesssolutionsllc.com  

    Address: 8000 Research Forest Dr, Ste 115 PMB 1168, The Woodlands, TX 77382

    You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights at the following address:

    U.S. Department of Health and Human Services  

    200 Independence Avenue, S.W., Washington, D.C. 20201  

    Phone: 1-877-696-6775  

    Website: http://www.hhs.gov/ocr/privacy/hipaa/complaints/

    Wellness Solutions, LLC will not retaliate against you for filing a complaint.

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    Client Rights, Expectations, & Responsibilities:

    Client Rights:


    As a client of Wellness Solutions, LLC, you have the following rights:


    Non-Discrimination: You have the right to receive services without discrimination based on age, race, ethnicity, gender, sexual orientation, religion, national origin, physical or mental disability, or any other personal attributes.

      

    Humane Environment: You have the right to a safe and humane environment that provides protection from harm and respects your privacy.


    Freedom from Abuse: You have the right to be free from abuse, neglect, and exploitation.


    Informed Treatment: You have the right to be informed about the treatment you will receive, including the risks, benefits, and available alternatives. You also have the right to refuse treatment and be informed of the possible consequences.


    Participation in Treatment Planning: You have the right to be actively involved in creating your treatment plan and to request changes to it at any time.


    Privacy and Confidentiality: You have the right to have your personal information kept private, with disclosures made only as required or permitted by law. You will be informed when your information may be shared without your explicit permission.


    Right to Withdraw Consent: You have the right to withdraw any consent or permission you have given at any time.


    Provider Information: You have the right to know about the qualifications and credentials of your provider, including their experience and training.


    Treatment Options: You have the right to be informed about available treatment options and the effectiveness of recommended treatments.


    Second Opinions and Referrals: You have the right to request a second opinion or a referral to another provider.


    Discharge Planning: You have the right to be involved in planning your discharge from treatment.


    Complaints and Grievances: You have the right to file complaints or grievances and receive a timely and fair response.


    Decision-Making: You have the right to be treated as capable of making your own decisions, with autonomy and respect.


    Respect and Dignity: You have the right to be treated with dignity, respect, and consideration throughout your care.


    Personal Preferences: You have the right to have your personal preferences, values, and needs respected and considered in your treatment.


    Clear Communication: You have the right to have all treatment matters explained to you in a way that you can easily understand.


    Client Expectations & Responsibilities:


    As a client of Wellness Solutions, LLC, you are expected to:


    Attend Appointments: Attend all scheduled appointments and reschedule or cancel within the appropriate time frame.


    Be Punctual: Attend appointments on time and adhere to care related turn around times and deadlines in a reasonable timeframe. 


    Complete Assignments: Complete any treatment assignments or homework as agreed upon with your provider.


    Financial Responsibility: Take responsibility for understanding your insurance benefits and policy provisions, including the network status of providers. Pay for all services provided, regardless of reimbursement from third-party payors.


    Honesty in Treatment: Be honest throughout the therapeutic process and communicate openly with your provider.


    Communicate Needs: Inform your provider if you feel your needs are not being met or if you have concerns about the quality of care or progress in treatment.


    Active Participation: Actively participate in developing and implementing your treatment plan.


    Follow Treatment Recommendations: Follow through with recommended treatments, including referrals to other providers or clinically relevant services.


    Report Safety Concerns: Inform your provider of any concerns related to safety, including thoughts of self-harm, suicidal behavior, substance use, or any other behavior that may pose a risk to yourself or others.


    Adhere to Policies: Comply with all policies and procedures of Wellness Solutions, LLC, including those outlined in the Informed Consent and Disclosure documents.


    Provide Accurate Information: Provide accurate and complete information about your health, symptoms, and mental health.


    Update Provider on Changes: Report any changes in your condition or symptoms in a timely and honest manner.


    Identify and Report Safety Issues: Identify and report any safety concerns that could affect your care.


    Comply with Safety Plans: Adhere to any safety plan developed with your provider.


    Respect Boundaries: Respect and abide by the boundaries of the therapeutic relationship.

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    Wellness Solutions, LLC Informed Consent & Disclosures (Part 1):


    Introduction to Wellness Solutions, LLC Informed Consent & Disclosures:

    • Informed consent and disclosures is a process of developing an understanding regarding the therapeutic process. It is a thorough, detailed, and ongoing information-sharing agreement between the provider and the client. The purpose of informed consent and disclosures is to ensure that the client and/or the client’s representative(s) is/are able to make an informed decision to engage in the treatment process with a comprehensive foundation of knowledge, such that, the client, and/or client’s representative(s) is/are educated about what they are consenting to when they agree to participate in treatment. 

     

    • Informed consent and disclosures provides an explanation about what treatment is, how treatment works, the possible benefits and risks of treatment, the boundaries (rules) of the therapeutic relationship, the responsibilities of the client, the responsibilities of the provider, the client’s financial responsibilities, and the client’s rights and limitations to privacy and confidentiality. 
      Informed consent and disclosures helps define the roles and responsibilities of all individuals engaged in the treatment process to effectively address and manage expectations by providing thorough information regarding consent and detailed disclosure regarding the treatment process. 

     

    Disclaimer About terminology:

    • For the purposes of this document the term "provider" includes any and all of the following: Clinical staff, Administrative staff, Billing Staff, and any/all Sub-Contractors, and any/all employees of Wellness Solutions, LLC, unless stated otherwise. For the purposes of this document, the term “client” includes any/or all of the following: Clients, the parent(s)/guardian(s) of a client, and/or a client’s representative(s). Additionally, throughout the intake document the they/them/their pronouns are used to refer to a client in order to ensure formatting and wording is cohesive and easier to understand. 

     

    Qualifications of  Owner & Staff:

    • Danielle C. Ellis, MA, MCJ, LPC, NCC has a BA in Psychology, MA in Professional Counseling Psychology, and a MA in Criminal Justice Administration. Dani is a Licensed Professional Counselor (LPC) in the State of Texas (License Number 63315). Additionally, she is also a National Certified Counselor (NCC) by the National Board of Certified Counselors. She is the owner of Wellness Solutions, LLC. For additional information on her education, experience, licensure, and work history please see the Wellness Solutions, LLC website (WWW.WellnessSsolutionsLLC.COM). 

     

    • The provider commits that any and all clinical staff providing direct care to clients meet or exceed the minimum requirements by law in the State of Texas for the position in which the staff provides care. Further, all Wellness Solutions, LLC clinical and non-clinical employees are professionally trained, educated, and meet all ethical and legal requirements by law. 

     

    Emergency and Crisis Information:

    • Wellness Solutions, LLC does not provide immediate, urgent, or emergent services. 

     

    • If you are in an emergency please call 911 or go to the nearest emergency room. 

     

    • If you are unable to schedule an appointment and feel that you cannot wait for an appointment please call 911 or go to the nearest emergency room. 

     

    • If one is experiencing symptoms that are so severe that one requires immediate, urgent, or emergent care then Wellness Solutions is not the appropriate level of care to address that level of risk and symptom severity. 

     

    • Please pursue treatment that can provide you with the emergency care you require to ensure safety by reporting to the nearest emergency room or calling 911. Please visit the Wellness Solutions website and click on the “Safety Resources” tab for emergency crisis resources.  

     

    • Please refer to the Wellness Solutions, LLC website for emergency and crisis resources and click on the “Safety Resources” tab. There are extensive resources to assist you with obtaining emergency services. 

     


    Be Kind. Be Respectful. Take Ownership of Your Energy:  

    • WS makes every effort to provide a comfortable, peaceful, safe, and accommodating environment for our clients and staff. WS is a therapeutic environment, community, and group practice that is welcoming, compassionate, open-minded, and accepting. Wellness Solutions will protect the energy of our healing space and the peace of mind, safety, and wellbeing of our clients and our staff. Wellness Solutions, LLC staff are not obligated to be the recipients of anyone’s projected, displaced, or inappropriate behavior or anger. Our administrative, billing and clinical staff will be respected as humans and as professionals. Anyone who mistreats, disrespects, or abuses WS staff will be immediately discharged from care, refused services, or banned from communications. 

     

     

    Clients are responsible for their own appointment management: 

    • Adult clients are expected to take adult responsibility for their own treatment. WS will not allow any adult other than the adult client to schedule appointments, discuss insurance or billing, or address any administrative, billing, or clinical issue. Wellness Solutions, LLC will not communicate with any adult other than the adult client regarding any care or treatment. 

     


    Telehealth Services: 

    • Wellness Solutions, LLC provides all services via telehealth. Clinicians will send an email with a link to a client appointment at the time of the scheduled appointment. 

     

    • The links are NOT sent in advance. 

     

    • The links are NOT reused each session. 

     

    • The emails with the links are sent at the start time of the session. 

     

    • We will send the email with the link to the appointment to the email account that the client registered with their intake forms. 

     

    • Clients are expected to have access to reliable independent technology to attend telehealth appointments. 

     

    • Clients should be in a private and stationary location to ensure the quality of the session is not compromised.

     

    • Clients should be able to maintain confidentiality and focus throughout the session which means ensuring that the client is in a private environment. 

     

    • Clients are not permitted to drive a car, operate heavy machinery, or participate in telehealth counseling sessions where confidentiality or privacy may be compromised. 

     

    • Client sessions should be in a distraction-free comfortable and private environment conducive to positive engagement. 

     

    • Clients are not permitted to conduct sessions in a public or semi-public environment, with other individuals present, while multitasking with other activities, or take calls or participate in any other interruptions while in session and if this takes place the session will end and the client will be responsible for the full fee of the session. 

     

     

    Provides Services for Clients Physically Located in the State of Texas: 

    • Wellness Solutions, LLC clinical staff are licensed mental health professionals in the State of Texas. 

     

    • All clients receiving Wellness Solutions, LLC telehealth services are required to be physically located in the State of Texas at the time of their telehealth appointment. 

     

    • Wellness Solutions, LLC is not able to provide services to clients who are physically located outside the State of Texas. 

     


    Definition of Counseling, Coaching, Therapy, Treatment, & Psychotherapy:

    • There are many interpretations and definitions to distinguish between counseling, psychotherapy, and treatment; however, contained herein is a general explanation of these terms to provide a basic understanding. 

     

    • Counseling includes assistance, guidance, and support resolving personal, emotional, and other difficulties or stressors. 

     

    • Psychotherapy is the treatment of psychological disorders or maladjustments utilizing clinical techniques. 

     

    • Counseling and psychotherapy are terms that are often used interchangeably though psychotherapy is best understood as based in clinical acuity including diagnosis and treatment of mental and behavioral disorders whereas counseling includes problems of everyday living that cause distress. 

     

    • Treatment or therapy may also be used as a synonym for counseling and psychotherapy. 

     

    • Counseling, psychotherapy, and treatment focus on problems or symptoms that rise to a level of severity that impair one’s ability to function at their optimal levels. The goal of counseling, psychotherapy, and treatment is to reduce, extinguish, or resolve symptoms and problems so the individual may recover and return to his/her previous optimal level of functioning.

     

    • Counseling, psychotherapy, and treatment achieve this through clinically appropriate evidence-based and empirically supported and validated interventions. Counseling and psychotherapy are provided by licensed mental health professionals who receive extensive education, training, supervision, and experience to develop and refine clinical and professional expertise. 

     

    • Counseling and psychotherapy education and licensure require a bachelor's degree and a master's degree, Ph.D., or PsyD in clinical psychology, clinical social work, or counseling. Counseling and psychotherapy education and licensure require ongoing training and consultation throughout one’s career. Counseling and psychotherapy licensure and treatment provide professional protections to clients, such as, privacy, confidentiality, and privileged communication. 

     

    • Licensed professional counselors follow professional, ethical standards, codes, and guidelines that are standardized and protected by law. In most circumstances, counseling and psychotherapy are covered benefits for managed care insurance policies. 

     

    • Coaching is a process to empower individuals to develop strategies for achieving their personal best. Coaching assists individuals identify and augment strengths. Coaching focuses on holistic health and wellness. Wellness is a state of optimal performance and is not merely the absence of disease. Coaching assists individuals with identifying and exploring strengths, goals, and future-oriented plans. Coaching does not include the assessment, diagnosis, intervention, or treatment of mental, behavioral, or psychological disorders. Though many counselors and psychotherapists do utilize coaching as a change-facilitation strategy to assist their client's coaching is not a treatment and does not have requirements for education, training, supervision, or licensure. Coaching does not provide a client with legal or ethical protections for privacy, confidentiality, and privileged communication. Further, coaching is not a covered benefit for managed care insurance policies. 

     

    The Therapeutic Process:

     

    • The therapeutic process includes the following: Identifying strengths, developing problem-solving techniques, coping skills, assertiveness skills, impulse control skills, boundary-setting skills, and communication skills. It may also include receiving positive supportive and empathic feedback, impartial objective feedback, polite challenges to illogical thought processes, respectful confrontation regarding maladaptive or inappropriate thinking, feeling, and behaving. 

     

    • The therapeutic process may entail education regarding mental health treatment and diagnosis, healthy nutrition and lifestyle choices as it relates to mental and behavioral health, stress management, spiritual or value identification and development, existential exploration, insight development, awareness of emotions, thoughts, and behaviors, assisting with goal development and achievement, accountability to support goal attainment, and learning about emotions, cognitive processes, and personal development. Further, the therapeutic process may include the following, but not limited to: Positive emotional support and validation, reframing experiences, resolving trauma, increasing understanding regarding motivation and behavior, and having a physical and emotionally safe place to explore one’s thoughts, feelings, and behaviors in a healing positive, and non-judgemental environment. 

     

    • The desired outcome of therapeutic treatment is to reduce or eliminate symptoms, reduce maladaptive thoughts, feelings, and behaviors, to reduce or eliminate distress, and to explore, as well as, implement individualized strategies and interventions to help a client achieve his/her goals. Further, desired outcomes of treatment may include but are not limited to the following: Increasing relationship satisfaction, improving relationship quality, assisting with identifying and augmenting strengths, learning healthy coping strategies, increasing functioning in specific areas of a client’s life, to identify and utilize resources, develop resilience and resourcefulness, to increase self-esteem, self-confidence, and self-efficacy.

     


    The Therapeutic Relationship & Professional Boundaries: 

     

    • Although therapy sessions may be very personal, the relationship between a client and therapist/provider is a professional relationship. A therapeutic relationship is an integral tool necessary for change to take place and to successfully achieve treatment goals. Therefore, there are very specific ethical and legal mandates pertaining to the therapeutic relationship to protect the client and facilitate positive change. The therapeutic relationship is a unique relationship where a client is able to explore, process, and develop insight, awareness, and skills to address symptoms, stressors, functional impairments, and issues that are personal, sensitive, painful, and vulnerable. 

     

    • The therapeutic relationship is private, confidential, and non-judgemental. It includes clearly defined rules and expectations. This is a unique relationship where clients can safely explore personal issues. The therapeutic relationship respects the beliefs, values, and dignity of the client. The only beliefs and values that are relevant in the therapeutic relationship are that of the client. The provider’s personal beliefs and values are not relevant in the therapeutic relationship and are not part of professional expertise or evidenced-based interventions. The therapeutic relationship promotes emotional safety and healing. Clients receive impartial, fair, objective, evidenced-based interventions and feedback. The client receives impartial feedback from a professional who has demonstrated expertise based on education, training, and experience in the assessment, diagnosis, and treatment of emotional and psychological disorders. The therapeutic relationship, though emotionally intimate, is not friendship nor is it permitted to extend beyond a professional relationship. The therapeutic relationship is time-limited, professional, and one-sided as it exists to meet the emotional needs of the client and not the provider. The provider takes the privileged position of a therapeutic relationship with clients very seriously and maintains a strict adherence to the ethical and legal boundaries inherent to that relationship. 

     

    • The client and provider do not engage in multiple relationships or dual relationships nor do they engage in activities or situations outside of the therapeutic treatment session. The provider does not engage in dual relationships which means that the provider will not have social relationships with clients or accept clients with whom the provider may have a social or family relationship. The client and provider do not engage in communication unless it is of a professional or clinical subject matter.  Professional boundaries are maintained at all times.

     

    • The therapeutic relationship is professional and based on timed sessions that are fee-for-service. The provider does not accept gifts from clients. The provider does not barter services due to potential conflicts of interest. 

     

    • If the client and provider should see one another in public the provider will not acknowledge the client unless the client acknowledges the provider first. The provider will make every effort to protect the client’s confidentiality. The provider will not confirm or deny that any individual is a client without consent to release information. Any and all concerns with regard to clinical boundary violations should be reported to the provider and provider’s supervisor immediately. 

     

     

    Therapeutic Journey and Motivation: 

     

    • Therapy is a client’s personal journey of change to develop insight, awareness, positive skills, and methods to think, feel, and behave in a healthy, adaptive, resourceful, and resilient way. If a client is not dedicated, motivated, and willing to demonstrate perseverance and commitment to the therapeutic process, then therapy will not help the client. Therefore, the counseling journey is the client’s responsibility. 

     

    • There is no help a provider can give a client that will overcome a lack of motivation, willingness, cooperativeness, or authentic engagement of the client. 
      It is the client’s responsibility to participate in treatment in an honest, forthcoming, transparent, and proactive manner. 
      In order for treatment to be successful, the client must do the work. There are no shortcuts to personal change. Simply talking about a problem or a symptom is not enough to facilitate necessary, sufficient, and measurable change. One must actively engage in the process of change and participate pro-actively for legitimate meaningful change to occur. 

     

    • The provider is a guide to help the client through the therapeutic journey and is not responsible for doing the work of therapy and change for the client. It is important to have realistic expectations regarding one’s potential for change and one’s willingness to participate and engage in the treatment process in an authentic and genuine manner. The desire for change is insufficient to facilitate and achieve actionable lasting personal change and transformation. The client is encouraged to recognize that really meaningful change is a process for which they are ultimately solely responsible.

     


    Services Provided & Populations Served: 

    • Wellness Solutions, LLC provides outpatient counseling and/or psychotherapy for mild, moderate, or severe mental health disorders, substance abuse disorders, eating disorders, self-injurious behaviors, and problems of everyday living. 
      Services are provided by appointment only. 

     

    • Wellness Solutions, LLC does not accept “walk-in” appointments. 
      Wellness Solutions, LLC provides telehealth appointments to clients who are physically located in the state of Texas. 

     

    • Wellness Solutions, LLC also provides or engages in community-based services such as food drives, clothing drives, toy drives, classes, seminars, mental health advocacy, educational advocacy, disability advocacy, and other pro-social activities. 

     

    • Wellness Solutions, LLC also provides coaching based on holistic positive psychology concepts. 

     

     

    All Services are Provided on a Voluntary Basis: 

     

    • The client has the right to consent to receive or refuse services at any time and for any reason. 

     

    • The client has the right to rescind consent for services at any time and for any reason. 

     

    • The client is provided services on a voluntary basis. 

     

    • The provider also reserves the right to refuse services to the client for any reason and at any time. 

     

    • The provider reserves the right to terminate care if the client is non-compliant with the treatment plan, is non-compliant with a safety plan, is unwilling/unable to pay for services, or for any reason deemed appropriate by the provider. 

     

    • Wellness Solutions, LLC does not provide court-ordered or mandatory outpatient counseling, psychotherapy, or treatment and will not provide care or participate in the treatment of a client or clinical case involving interactions with the legal system. 

     

     


    Modalities of Treatment: 

    • The following is a list of treatment of modalities, theoretical orientations, clinical interventions utilized by Wellness Solutions, LLC: Psychotherapy, Counseling, Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Eye Movement Desensitization and Reprocessing (EMDR), Rational Emotive Behavior Therapy (REBT), Person-Centered Therapy, Mindfulness-Based Cognitive Therapies, Boundary Setting, Communication Skills, Assertiveness Skills, and counseling and therapeutic interventions and activities.  Wellness Solutions, LLC only utilizes and endorses therapeutic interventions that are Empirically Supported Treatment (EST) validated and Evidenced-Based Treatments (EBT). Based on the client’s needs there may be other treatment modalities, theoretical orientations, or clinical interventions used by Wellness Solutions, LLC.

     

     


    General Session Description: 

     

    • Sessions are 45-50 minutes in duration. In the event, a session exceeds 45-50 minutes the client will be charged in accordance with Wellness Solutions, LLC fees. The client should be aware that fees for session time overage are not covered by insurance. 
      Sessions include the client and clinician discussing problems, symptoms, and presenting concerns. 

     

    • Sessions include encouraging the client to explore, develop, learn, and practice coping skills, problem-solving skills, accessing appropriate support systems or resources, and other psychotherapeutic skills to decrease symptoms, improve functioning, and resolve areas of distress. 

     

    • Sessions include assisting the client to attain the client’s highest level of functioning, alleviate symptoms causing distress to the client, and provide the client with skills, strategies, resources, and support systems.

     

    • Sessions may include exploring, learning, practicing, utilizing, and accessing treatment resources, such as articles, worksheets, books, apps, therapeutic homework assignments, and videos to assist the client complete treatment objectives and achieve treatment plan goals. 

     

    • Sessions may include reviewing and processing assignments to be practiced or worked on outside of the session to assist clients with skill development and goal achievement. 

     

    • Sessions may include assignments outside of the sessions to assist the client to learn, develop, and practice skills to assist the client to achieve his/her goals. 
      Interventions are individualized based on the specific identified symptoms, problems, needs, objectives, and goals of the client. 
      Interventions and assignments range from a diverse range of media, technology, information, resources, and supports that best suit a client’s learning style and preferences. 

     

     

    • Clients are strongly encouraged and recommended to bring three topics or areas of concern to address in the session. This policy empowers a client to take responsibility for their session time and use their session time in an effective manner. It is not the responsibility of the clinical staff to determine or uncover the topics a client wants to discuss. 

     

     

    First Session/Intake Session Description:

     

    • In the first session, the provider will discuss and explain informed consent and other relevant and useful information. 

     

    • The provider will conduct an assessment that includes asking questions regarding the client’s history, precipitating events for seeking treatment, current strengths and stressful concerns, goals of treatment, and obtaining information to assist in the treatment process. 

     

    • The client and the provider will collaborate to share information, establish rapport, and develop an understanding of the expectations and goals of treatment. 
      Subsequent Session Description (Second Session And Further):

     

    • Sessions include discussing problems, symptoms, and areas of concern, as well as, strengths, resources, and interventions to assist the client to develop coping skills, decision-making skills, strategies to increase effectiveness, and other clinical techniques to help a client achieve their goals. Sessions may feel uplifting and energizing. Sessions may also feel tired, heavy, or anxiety-provoking. There is a vast array of thoughts and feelings one may experience throughout the course of treatment. Sessions vary in content and results based on the content of topics and symptoms identified or the types of skills being learned and developed. 

     

    • A client is expected to inform the provider if the client is having concerns regarding safety, suicidal thoughts or feelings, homicidal thoughts or feelings, self-harm thoughts or behaviors, psychotic symptoms, or any other thoughts, feelings, or behaviors that may cause risk for harm or safety. 

     

    • A client is expected to be prepared for the session and bring topics that they would like to discuss in session and not anticipate that the provider will “mind read” or “guess” what topic, symptom, or problem that the client may want to address. 
      Having expertise in mental health does not include mind-reading as a skill set. Your provider cannot assist you if you are not forthcoming, honest, transparent, and engaged in your care. 

     

    • The subject matter of sessions is the ultimate responsibility of the client, however; a provider may exercise clinical discretion in guiding a session and addressing symptoms, skill development, problem-solving, and interventions. 
      Treatment Duration/Progress In Treatment/Length of Stay In Treatment: 

     

    • The duration of time in therapy and anticipated length of stay for outpatient counseling, coaching, and psychotherapy is dependent on multiple variables, which include but are not limited to, the presenting problem, diagnosis, severity of areas of concern, compliance to the treatment plan, and motivation of the client. The length of time in treatment and progress towards goals is based on many variables which include the client’s specific needs, objectives, and goals. Treatment duration and progress, regardless of symptom severity or acuity, is significantly impacted by a client’s willingness to participate honestly and authentically, as well as, one’s consistent and determined motivation, access to resources, and the presence of a positive healthy support system. 

     

    • The average length of stay for short-term solution-focused mild stressors that include one problem of everyday living is approximately ten sessions; however, every individual and presenting problem is unique. Individuals with moderate to severe clinical mental health or substance abuse presenting problems may expect an extended length of stay that exceeds 35-50 sessions in one year, again every individual and presenting problem is unique. 

     

    • Individuals seeking treatment for trauma recovery, eating disorders, psychosis, or self-injury may generally expect significantly extended lengths of stay in treatment compared to other moderate to severe mental health presenting problems. 
      Treatment progress is determined by achieving identified objectives and goals. Periodically, treatment objectives and goals will be evaluated to ensure one is benefiting from treatment. Throughout the treatment episode, a client may achieve objectives and goals only to determine that they have new needs and concerns to be addressed, at which time, the client and provider collaborate together and develop new objectives and goals. Further, a client may initially seek treatment for a specific area of concern and discover additional areas of concern to be included in their treatment plan.  

     

    Subsequent Session Description (Second Session And Further):

     

    • Sessions include discussing problems, symptoms, and areas of concern, as well as, strengths, resources, and interventions to assist the client to develop coping skills, decision-making skills, strategies to increase effectiveness, and other clinical techniques to help a client achieve their goals. Sessions may feel uplifting and energizing. Sessions may also feel tired, heavy, or anxiety-provoking. There is a vast array of thoughts and feelings one may experience throughout the course of treatment. Sessions vary in content and results based on the content of topics and symptoms identified or the types of skills being learned and developed. 

     

    • A client is expected to inform the provider if the client is having concerns regarding safety, suicidal thoughts or feelings, homicidal thoughts or feelings, self-harm thoughts or behaviors, psychotic symptoms, or any other thoughts, feelings, or behaviors that may cause risk for harm or safety. 

     

    • A client is expected to be prepared for the session and bring topics that they would like to discuss in session and not anticipate that the provider will “mind read” or “guess” what topic, symptom, or problem that the client may want to address. 
      Having expertise in mental health does not include mind-reading as a skill set. Your provider cannot assist you if you are not forthcoming, honest, transparent, and engaged in your care. 

     

    • The subject matter of sessions is the ultimate responsibility of the client, however; a provider may exercise clinical discretion in guiding a session and addressing symptoms, skill development, problem-solving, and interventions. 

     


    Treatment Duration/Progress In Treatment/Length of Stay In Treatment: 

     

    • The duration of time in therapy and anticipated length of stay for outpatient counseling, coaching, and psychotherapy is dependent on multiple variables, which include but are not limited to, the presenting problem, diagnosis, severity of areas of concern, compliance to the treatment plan, and motivation of the client. The length of time in treatment and progress towards goals is based on many variables which include the client’s specific needs, objectives, and goals. Treatment duration and progress, regardless of symptom severity or acuity, is significantly impacted by a client’s willingness to participate honestly and authentically, as well as, one’s consistent and determined motivation, access to resources, and the presence of a positive healthy support system. 

     

    • The average length of stay for short-term solution-focused mild stressors that include one problem of everyday living is approximately ten sessions; however, every individual and presenting problem is unique. Individuals with moderate to severe clinical mental health or substance abuse presenting problems may expect an extended length of stay that exceeds 35-50 sessions in one year, again every individual and presenting problem is unique. 

     

    • Individuals seeking treatment for trauma recovery, eating disorders, psychosis, or self-injury may generally expect significantly extended lengths of stay in treatment compared to other moderate to severe mental health presenting problems. 

     

    • Treatment progress is determined by achieving identified objectives and goals. Periodically, treatment objectives and goals will be evaluated to ensure one is benefiting from treatment. Throughout the treatment episode, a client may achieve objectives and goals only to determine that they have new needs and concerns to be addressed, at which time, the client and provider collaborate together and develop new objectives and goals. Further, a client may initially seek treatment for a specific area of concern and discover additional areas of concern to be included in their treatment plan.  

     


    Excluded Services: 

     

    • Excluded conditions, diagnosis, or client circumstances may include but are not limited to the following: Clients with anger management or impulse control disorders, clients who have a history of or are currently seeking treatment for sexual compulsion, sexual dysfunction, sexual addiction, or compulsive gambling. 

     

    • Wellness Solutions, LLC does not provide services to any individuals with a history of presenting problems of aggression, violence, threatening behavior, and or violent criminal behavior or is the subject of a current or previous order of protection/restraining order (as the perpetrator/defendant). 

     

    • Further excluded services are as follows but not limited to: Consultation, evaluation, or counseling in regards to child custody of ANY nature, home assessment, or evaluations for custody or making recommendations for child custody, psychological testing services, neurological testing, fitness for duty evaluations for law enforcement or military, substance abuse professional evaluations (SAP), social services evaluations, APS/CPS evaluations, or wrap-around services for community-based supports, Social Security evaluations, dementia evaluations or assessment, issues specifically related to developmental disorders as a primary diagnosis, or early childhood problems or concerns for mental retardation as a primary diagnosis. 

     

    • Wellness Solutions, LLC utilizes the medical model and 12 Step Model to addiction and will also include additional substance abuse treatment/self-help models as long as said models are part of an abstinence-based treatment model. Wellness Solutions, LLC does not endorse nor provide treatment for any individually prescribed Methadone maintenance or Suboxone. 

     

    • Wellness Solutions, LLC does not provide services to clients who have situations or circumstances that may include interactions with the legal system. Wellness Solutions, LLC does not provide forensic services of any kind and does not provide court testimony. 

     

    • Wellness Solutions, LLC does not provide services to clients participating in clinical cases involving worker's compensation concerns and/or claims. 

     

    • Wellness Solutions, LLC does not provide emergency behavioral health, mental health, and/or chemical dependency services or emergency services of any kind. Wellness Solutions, LLC does not have 24-hour emergency behavioral health, mental health, and/or chemical dependency crisis intervention services. 

     

    • Wellness Solutions, LLC does not assess or provide assistance with short-term disability, long-term disability, workers compensation, or FMLA assessment, claims, or filing. 

     

    • Wellness Solutions, LLC does not provide off-site or in-home behavioral health, mental health, and/or chemical dependency services. 

     

    • Wellness Solutions, LLC does not provide involuntary therapeutic services of any type. 

     

     

    Risks Associated With Treatment: 

     

    • It is important to be aware that counseling, psychotherapy, and treatment have potential benefits and risks associated with treatment. 

     

    • Sessions involve discussions of potentially sensitive information surrounding relationships, trauma, personal or emotional issues, and exploring painful psychological experiences which may be difficult to cope with and potentially cause distress. There are times when counseling and psychotherapy can cause emotional distress as you will be addressing issues that may have been upsetting in the past. Discussion of previous distressing events and feelings may include re-experiencing these events and possibly recalling information that one did not remember previously which can cause increased negative feelings, symptoms, and functional impairments. Therefore, one should know that there are risks involved with seeking treatment. 

     

    • If the client begins to experience an increase in symptoms it is very important to inform your provider. There is the possibility that a client may experience an increase in symptoms, resolve some symptoms only to develop new symptoms, or have unintentional or unforeseen consequences as a result of engaging in the therapeutic process. There are times when personal growth and development are preceded by emotional discomfort. Upon knowledge that treatment may be increasing distress, the client and provider can work together collaboratively to ensure that the client’s treatment plan, safety plan, coping skills, support system, and resources address the client’s needs to address these clinical issues and reduce distress. 

     

    • Sessions can significantly reduce the number of symptoms or impairment in functioning a client is experiencing, improve relationships, and or resolve specific areas of concern or distress. While counseling, psychotherapy, and coaching have the potential to improve quality of life, there are occasions in which you may experience increased symptoms until sufficient progress is achieved. 

     

    • Counseling and psychotherapy, itself, may not resolve all concerns and symptoms. The attainment of treatment goals is dependent on multiple factors including the quality of work from the client, the client’s support system, the client’s access to resources, the client’s ability to access healthcare, and many others. In the event, a client does not experience positive progress, especially once made aware of concerns regarding a resurgence in symptoms, and treatment plan changes have been sufficiently pursued, then it may become necessary to refer the client to an alternate provider. 

     

    • Please be aware, to derive maximum benefit from treatment and the counseling relationship it is imperative to engage with honesty, transparency, motivation, willingness to change, and take ownership and responsibility for one’s thoughts, feelings, and behaviors. 

     

    • Wellness Solutions, LLC is not able to make any type of guarantee for any specific results regarding counseling outcomes or treatment goal attainment. It is unethical and illegal for licensed mental health professionals to make guarantees or promises regarding treatment results, cures, or offer misleading or false expectations regarding treatment outcomes. 

     

    • There may be clinical situations or circumstances where a client may require a referral to a higher level of care to stabilize his/her symptom severity and decompensation in functioning. Wellness Solutions, LLC may recommend alternative providers or treatments based on a client’s lack of therapeutic progress or decompensation in function in order to ethically attend to the client’s needs. Examples of potential treatment alternatives may include the following: A referral to another outpatient provider who specializes in the area of expertise relevant to the client’s presentation of symptoms, referral to a higher level of care such as an intensive outpatient program (IOP), partial hospitalization program (PHP), residential treatment program (RTC), or inpatient level of care for acute stabilization (IP), and/or referral to neuropsychological testing for diagnostic testing, and/or referral to a psychiatrist for a consultation to determine if medication management is clinically indicated. 

     

    Client Administrative Discharge, Client Termination, Financial Discharge, & Self-Discharge From Services:  

     

    • Clients who self-discharge, cancel upcoming appointments and do not reschedule appointments, or no show for appointments, and do not respond to outreach are considered self-discharged from care or an administrative discharge from care. 
      In order to ensure discharged clients do not incur any considerations regarding abandonment, please be aware that the proper referrals are contained herein, and that Wellness Solutions, LLC provides proper termination when the client verbalizes a desire to terminate care and requests proper termination as appropriate. Proper termination includes three termination sessions. If a client chooses to terminate care by canceling up-coming appointments or not responding to outreach then they forfeit proper termination sessions. 

     

    • Clients who have not had an appointment for more than 2 months or 60 days are considered discharged from care administratively. 

     

    • If a former client would like to re-admit to care then they are welcome to do so as long as they are in good standing and were not terminated from care. 
      If a client self-discharges from care and the client would like to receive discharge disposition information or referrals to another provider the client is responsible for contacting Wellness Solutions, LLC to request the aforementioned information. 
      Clients do not receive specific individualized discharge disposition information unless the client terminates appropriately. Proper termination includes but is not limited to, the client discharges as part of a therapeutic agreement and successful achievement of treatment goals with the provider or unless the client contacts the provider and requests specific individualized discharge disposition information. 
      The client will find referral resources contained herein should the client require or need outpatient resources and referrals and the client opts to self-terminate care without receiving discharge recommendations. 

     

    • The referral resources contained herein act as discharge disposition in the absence of a termination session and/or a discharge termination summary or documentation and absolves any/all provider(s) of abandonment responsibilities. 
      The client agrees to hold harmless Wellness Solutions, LLC from any and all concerns pertaining to improper termination, improper discharge, or abandonment when a client discharges administratively, financially, or without the proper transition of care. 

     

    • In the closing phase of the treatment process, a client may decrease the frequency of sessions as the necessity or need for services also decreases. It is helpful to discuss and process the pending discharge from care which is also referred to as client termination so a client may have the opportunity to reflect and process on his/her treatment journey. 

     

    • It is beneficial to utilize the treatment environment and client termination process to identify one’s views on change, achievement, struggles, and most importantly have the opportunity to experience grief through a relationship ending. 

     

    • Discharge from care based on achieving treatment objectives and goals is a positive outcome; however, many clients encounter uncomfortable emotions as they participate in the termination process as the therapeutic relationship is both professional and a very emotionally meaningful and powerful relationship. Therefore, the client is encouraged to terminate appropriately in order to avoid emotional unfinished business. A client may discharge from treatment at any time. However, engaging in the termination process assists a client to appropriately say goodbye in a purposeful and meaningful way. 

     

    • Clients who discharge from care are welcome to return to care should new areas of concern arise, they recognize that they may benefit from returning to treatment, and they are in good standing. 

     

    • Clients who discharge from care based on achieving treatment objectives and goals will receive a specific individualized discharge disposition with instructions regarding how they should continue their progress and include referrals and resources to assist the client. 

     

     

    Client Disposition & Discharge Referral Information: 

    The following is the recommended resources and generalized administrative discharge, financial discharge, and clinical discharge information for all clients who choose to self-discharge: 

     

    • Call/follow-up with your Primary Care Physician (PCP) or family doctor.

     

    • Call/follow-up with your psychiatrist or mental health prescriber. 

     

    • Call the 800 number for one’s insurance company (found on an insurance card) and request a list of in-network providers

     

    • Visit the member website for one’s insurance company to perform an online search for in-network outpatient providers. 

     

    • Visit www.psychologytoday.com , www.goodtherapy.org , or www.theravive.com to search for and find outpatient providers. 

     

    • Call Family Psychiatry of The Woodlands (281-367-1015) or visit http://www.woodlandspsych.com/

     

    • Call The Woodlands Behavioral Health and Wellness Center (281-528-4226) or visit http://www.addwoodlands.com/

     

    • Call Lone Star Family Health Center (936-539-4004) or visit https://www.lonestarfamily.org/

     

    • If you are in an emergency situation or crisis situation you can refer to the Wellness Solutions, LLC website for resources, or go to the nearest emergency room. 

     

    • If you are in need of emergency or crisis resources then please refer to the Wellness Solutions, LLC website and click on the “Safety Resources” tab for extensive information that can be of assistance. http://www.WellnessSolutionsLLC.com This information is also available on the Wellness Solutions, LLC website under the “Safety Resources” tab. 

     

    Privacy, Confidentiality, & Privilege: 

    • Please be advised that there are ethical and legal considerations regarding privacy, confidentiality, and privilege as it relates to one’s information disclosed in treatment and one’s expectation to maintain control over his/her information. 

     

    • Privacy: Involves an individual’s right to control the disclosure of personal information and to keep information to oneself. When a client gives professional permission or consent to release information the professional only releases the minimum information necessary for the disclosure and within the parameters the client specifically allows in the consent.

     

    • Confidentiality: Refers to the professional’s ethical duty to protect private information, including all information obtained in the professional therapeutic relationship. A mental health professional has a professional, ethical, and legal duty to safeguard confidential information from unauthorized disclosure. As a general rule, confidential information is disclosed only when mandated by law or with the client’s written authorization. There are limitations and exceptions, however; which include dangerousness to self or danger to others, or the abuse, neglect, or exploitation of minors, the elderly, or individuals considered vulnerable or at risk.

     

    • Privilege: A legal concept limited to the protection of confidential information from forced disclosure in court and other legal proceedings. Privilege refers to the legal obligation that protects a client against forced disclosure of confidential information in court and in other legal proceedings. Privilege also has limits in legal parameters. 

     

    • The provider will respect, protect, and adhere to all ethical and legal obligations with regards to protecting your privacy, confidentiality, and protected health information (PHI). The client or client’s representative and/or parent(s)/guardian(s) must be aware that no one has complete absolute confidentiality. The client may sign a consent to release information form if he/she would like to give permission to the provider to coordinate and/or share the client’s confidential information with a third party.
      The provider is legally and ethically obligated to report the imminent threat of harm to self or others to proper authorities. 

     

    • The client is advised that the provider will report threats of imminent harm to oneself or others in order to facilitate and ensure the safety of the client and/or others. 

     

    • The provider is legally and ethically compelled to report suspected child abuse, elder abuse, and/or abuse of adults who are disabled or unable to care for themselves. 

     

    • The provider is a mandated court reporter, as such, the provider is legally and ethically compelled to report ANY suspected or reported abuse to minors, the elderly, adults who are at risk for exploitation/abuse or are disabled or unable to care for themselves. Wellness Solutions, LLC is ethically and legally mandated to report any and all suspected verbal, emotional, psychological, physical, financial, and sexual abuse. 

     

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    Wellness Solutions, LLC Informed Consent & Disclosures (Part 2) 

     

    EMDR Therapy Disclaimer: 

     

    • Eye Movement Desensitization and Reprocessing (EMDR) is a therapeutic approach designed to help individuals process and resolve distressing memories and experiences. While EMDR has been shown to be effective for many people, results can vary. Some clients may experience temporary emotional discomfort or increased distress during or after sessions as they process traumatic memories. This is a normal part of the therapeutic process, but please inform your therapist if you have any concerns. EMDR should not be considered a substitute for other forms of mental health treatment if needed.

     

    • EMDR therapy involves processing traumatic memories by using guided eye movements or other forms of bilateral stimulation. While many clients benefit from EMDR, there are potential risks, including temporary intensification of symptoms or emotional discomfort. These effects are usually short-term and may diminish as therapy progresses. Your therapist will work with you to address any concerns and adjust the treatment as necessary. It is important to communicate openly about your experiences during therapy to ensure the approach remains appropriate for you.

     

    • During EMDR therapy, you may be asked to recall distressing events while focusing on external stimuli, such as guided eye movements. This process can lead to temporary increases in emotional or physical symptoms. These responses are typically part of the therapeutic process and can be addressed with your therapist. EMDR is not a quick fix, and progress varies among individuals. Your therapist will provide support throughout the process and will work with you to develop a treatment plan tailored to your needs.

     

    • As with all therapeutic approaches, confidentiality is a key component of EMDR therapy. However, it is important to understand that while EMDR can be highly effective, there are no guarantees of specific outcomes. You may experience varying levels of distress or emotional release as part of the process. If you have any concerns about how EMDR might impact you, please discuss them with your therapist. Your therapist will work to ensure that your treatment remains appropriate and responsive to your needs.

     

    • EMDR therapy involves recalling and processing distressing memories through specific techniques, which may sometimes lead to temporary discomfort or emotional disturbance. This is a normal part of the therapy and is usually managed within the therapeutic setting. Participation in EMDR is voluntary, and you have the right to withdraw from therapy at any time if you feel it is not beneficial or if you experience undue distress. Please communicate openly with your therapist about any concerns or symptoms you encounter during the process.

     

    • EMDR intensive packages canceled or rescheduled will incur a $100.00 rescheduling fee for every time the session is rescheduled or canceled. EMDR packages canceled or rescheduled more than 3 times will incur a $100.00 rescheduling fee. 

    ​

    • If a client purchases an individual package or an EMDR intensive package and does not use the service within 90 days then the client forfeits the unused services. 

     

    • There are no full or partial refunds for any EMDR services. ​

     

    • EMDR services require extended session times of 90 minutes of more which is not covered by insurance. Our EMDR services are not billed to insurance. Wellness Solutions, LLC does not provide a super bill to clients for clients to bill their own insurance.  

    ​

    • If a client purchases a weekly individual package or EMDR intensive package and does not use the service within 90 days then the client forfeits the unused services. 

     

    Client Safety: 

     

    • The client agrees to inform the provider if the client is non-compliant with his or her treatment plan, if the client is non-compliant with medication management from their prescriber, if the client is using illegal drugs, if the client is abusing prescription drugs, if the client is abusing over the counter drugs, if the client is actively engaging in self-injurious behavior, and/or if the client is being abused or is abusing others. 

     

    • The client also agrees to inform the provider immediately if the client has relapsed on drugs, relapsed on alcohol, relapsed on a nutritional plan (for eating disorder clients), or is engaging in any activities that may put the client or someone else at risk or harm. 
      The client acknowledges that failure to disclose this information to the provider may be seriously detrimental to the client and/or others and may result in immediate discharge from services. The provider takes the client's safety and the safety of the public very seriously. 

     

    • The provider is legally and ethically obligated to take any and all threats to self, to others, or to the public seriously and report these concerns to the proper authorities. All clients are expected and responsible for cooperating and complying with their treatment plan and safety plan. In the event a client is uncooperative, non-compliant, or does not meet their expectations and responsibilities with their treatment plan, safety plan, the Wellness Solutions, LLC informed consent and disclosures, and/or Wellness Solutions policies and procedures then the provider is not responsible for any clinical complications, clinical complexities, negative clinical outcomes, lack of clinical progress, or unanticipated clinical events the client may have as a result. 

     

    • The provider will not be held responsible for the client’s failure to accurately, honestly, and proactively self-report symptoms, behaviors, thoughts, or compulsions that constitute a safety risk or concern. 

     

    • The provider will pursue any and all ethical and legal options available to protect the client and/or the public when there is a clinical reason to believe that there are safety concerns for a client and/or the public which may include breaching confidentiality to protect the client, protect the public, or to intervene or prevent a potential safety or risk related concern or behavior. 

     

    Maintaining Integrity and Privacy in the Treatment Session and Treatment Environment: 

     

    • Clients are not allowed to use any type of electronic device to audio record, video record, or document in any way the private and confidential therapy sessions with Wellness Solutions, LLC. 

     

    • Any/all audio or video recording of counseling sessions is strictly prohibited. 
      Wellness Solutions, LLC does not permit clients to engage in any form of electronic recording of Wellness Solutions, LLC services in client sessions. 

     

    • Clients are hereby advised that they do not have permission to engage in electronic recording on Wellness Solutions, LLC premises or with in-person communications, including but not limited to, Wellness Solutions, LLC treatment sessions. 

     

    Grievances, Concerns, & Complaints Procedures: 

     

    • The provider welcomes client constructive feedback, concerns, comments, and complaints. Wellness Solutions, LLC views all client feedback as an opportunity to grow, develop, and improve services and quality of care. Should a client have a concern, complaint, or grievance regarding the care they receive, then the client agrees that prior to filing a formal complaint with a licensure committee/board, filing a formal complaint with any accrediting body, filing a complaint with any consumer agency/body, prior to pursuing legal action of any type, or filing a lawsuit the client will follow the Wellness Solutions, LLC Grievances, Concerns, & Complaints Procedures. 

     

    • Hence, prior to any administrative, legal, or consumer action of any type, the client/client guardian agrees to follow the Wellness Solutions, LLC Grievances, Concerns, & Complaints Procedures. The Wellness Solutions, LLC Grievances, Concerns, & Complaints Procedure Is As Follows: 1.) Inform the Wellness Solutions, LLC of the issue both verbally and in writing detailing the specific concern and how the client would like the issue resolved. The client must have the ability or right to discuss the client’s care with the provider in order to bring forth a complaint. 1a.) To contact the Wellness Solutions, LLC administrator please call the main number and request the administrator. The Wellness Solutions, LLC main number is 713-893-3989. 1b.) The Wellness Solutions, LLC administrator may be reached by email: Admin@WellnessSolutionsLLC.com and/or Clinical@WellnessSolutionsLLC.com 2.) The client must provide specific suggestions that Wellness Solutions, LLC can address the specific concern that is being brought forth in order to ensure that Wellness Solutions, LLC can effectively assertively implement new policies and procedures to address the client’s needs or concerns.  3.) The client agrees to bring concerns about the provider to the Wellness Solutions, LLC Administrator in a timely manner of no more than 1 month/30 days after the issue of concern transpired. All issues/concerns that exceed 1 month/30 days from the date the issue of concern transpired may be dismissed due to expiration of the concern. Wellness Solutions, LLC reserves the right to determine if areas of concern are to be addressed after the 1 month/30 day expiration. If the client does not initiate the Wellness Solutions, LLC grievance policy within the time frame permitted then the client agrees to forfeit all complaints with any accrediting body, filing a complaint with any consumer agency/body, prior to pursuing legal action of any type, or filing a lawsuit. By agreeing to this policy the client agrees to forfeit all actions if the complaint is not reported to Wellness Solutions, LLC within the aforementioned time frame and instead hold Wellness Solutions, LLC harmless to all real or perceived infractions. 4.) The client will allow the Wellness Solutions, LLC Administrator a minimum of 2 weeks/14 days (from the date notified in writing of the issue) to investigate and attempt to rectify the concern. 5.) If after a good faith attempt by the provider has been made to rectify the concern and the client is still not satisfied with the result then the client also agrees that the client and the provider will utilize a formal mediation process or alternative dispute resolution procedure. If the client chooses to engage in mediation proceedings or alternative dispute resolution procedure the client incurs half the cost of the aforementioned mediation or alternative dispute resolution proceedings. If the need for mediation presents itself the provider reserves the right to select the mediator. The client agrees to submit to the finding of the mediation process or alternative dispute resolution proceedings and forfeits all future actions and also forfeits any additional actions. 6.) In the event a client makes a grievance, concern, or complaint against Wellness Solutions, LLC and the client does not follow the agreed upon aforementioned process then the client is in violation of a contractual agreement with Wellness Solutions, LLC as per The Wellness Solutions Informed Consent and Disclosures and agrees to incur all costs to Wellness Solutions, LLC resulting from the grievance including but not limited to fees for consultants, attorneys, mediators, clinical fees, case management fees, and legal fees. 7.) In the event a client makes a grievance, concern, or complaint against Wellness Solutions, LLC in bad faith or without engaging in the aforementioned agreed upon process Wellness Solutions, LLC reserves the right to defend itself in any and all proceedings and venues which may include legal action and the client agrees to incur all fees and expenses resulting thereof. 8.) In the event a client commits an action against Wellness Solutions, LLC or any staff member of Wellness Solutions, LLC such as a threat, act of aggression or vandalism, or any such illegal or harassing act the client may incur legal action on behalf of Wellness Solutions, LLC and or staff to ensure one’s reputation and/or physical or emotional safety are protected. 9.) In the event a client gives cause for Wellness Solutions, LLC to seek professional consultation, legal consultation, legal counsel, and/or professional services to address any/all client concerns, complaints, and/or grievances the client/client guardian is/are advised the client incurs all financial responsibility for said fees and services, as well as, the clinical time and case management time to address these concerns. 10.) In the event a client wishes to file a complaint against the provider the client can contact the Texas State Board of Licensed Professional Counselors. Wellness Solutions, LLC does not allow any type of retaliation against individuals who voice a concern or complaint regarding his/her care. The State of Texas Board of Examiners of Licensed Professional Counselors (LPC) Complaints Management and Investigations Section:P. O. Box 141369 Austin, Texas 78714-1369 800-942-5540 Website: https://www.dshs.texas.gov/counselor/lpc_complaint.shtm

     

    Social Media Policy: 

     

    • The provider maintains a professional website and multiple social media and electronic internet referral websites. Clients are not required to participate in any social media. Clients are encouraged to exercise good judgment and discretion with their social media choices. If the client does participate in the provider’s professional social media then the provider does not take any responsibility for issues pertaining to privacy or confidentiality with regard to social media. Clients are advised to assume that there is no privacy and no confidentiality with regards to participation in any social media whatsoever. The provider does not accept any responsibility or liability with regards to privacy and confidentiality in social media. Clients who chose to participate in Wellness Solutions, LLC social media are advised that there is no confidentiality, no privacy, and no privilege as it pertains to information a client makes public or shares with said social media, communications, or information exchange platforms. Further, clients who choose to participate on Wellness Solutions, LLC social media, community events or activities, or social events do not have any reasonable expectation for confidentiality, privacy, or privilege for participation in and with said communications and behaviors directly related to the client’s voluntary participation and disclosures. Wellness Solutions, LLC is not responsible for maintaining privacy, confidentiality, or privilege in situations, circumstances, social media platforms, communications platforms, or social situations or activities when a client chooses to participate in online activities. Moreover, Wellness Solutions, LLC is not responsible for a client’s willful participation in social media, public events, or community activities and any potential for breaches of confidentiality, privacy, or privilege that may result henceforth. Wellness Solutions, LLC supports the ethical and legal rights of a client to be respected, to make informed decisions, and to self-determine with decision making. 

     

    • The provider conducts regular and routine surveys for quality assessment which may also include inviting clients to provide valuable feedback. This information may be used in a variety of contexts including but not limited to the following: Marketing, social media, reviews, or advertising. The information in question will be appropriately redacted or protected, when that is within the control or discretion of the provider, in order to ensure that the client’s identity and PHI is not released. 

     


    Protection of Staff Safety, Security,  & Services: 

     

    • The provider will make every effort to maintain and protect the safety, security, and professional reputation of all staff, clients, support system, and guests of Wellness Solutions, LLC. 

     

    • The provider does not tolerate aggressive, threatening, intimidating, harassing, or inappropriate behaviors or communication. 

     

    • The provider reserves the right to discharge the client or have any individual engaging in the aforementioned concerning behaviors or communication removed or blocked from Wellness Solutions, LLC communication channels or premises. 

     

    • The provider will protect the safety, security, and integrity of the therapeutic environment of staff, clients, client family or client support system. 

     

    • Wellness Solutions, LLC clients will be discharged from care should they themselves or their family, support system, or representatives inappropriate behavior or communication and/or for sending/posting harassing, threatening, or inappropriate content on the provider's social media, message board, or any Wellness Solutions, LLC public or private communication forum. 

     

    • The provider reserves the right to defend and protect the provider's reputation in situations where a client posts defaming, inflammatory, dishonest, or inappropriate information or content in any public forum, electronic forum, social media, or review site. The provider reserves the right to request a client or any other agent of the client to remove defaming, inflammatory, dishonest, or inappropriate information or content in any public forum, electronic forum, social media, or review site. 

     

    • The provider reserves the right to pursue criminal and/or civil actions against the client in the event the client or any other agent of the client refuses to remove the content. 
      The client will be held responsible for any and all costs that the provider incurs to defend, protect, or correct the provider’s reputation. 

     

    • In the event a client gives cause for Wellness Solutions, LLC to seek professional consultation, legal consultation, legal counsel, online reputation management consultation and services, and/or professional services to address any/all client concerns, complaints, and/or grievances the client is advised the client incurs all financial responsibility for said fees and services, as well as, the clinical time and case management time to address these concerns.

     


    Clinical Continuity and Records: 

     

    • In the event the assigned therapist on your file leaves our practice, is incapacitated, or deceased then members of the provider’s staff will contact you and either reassign your case to another therapist in Wellness Solutions, LLC or give you a referral to another therapist based on your needs, preferences, and availability. Wellness Solutions, LLC puts forth that in the event of incapacitation or death of the clinical director the client’s clinical records will be maintained by Wellness Solutions, LLC executive and administrative staff. The clinical director gives consent to allow the executive and administrative directors or the interim clinical director to take possession/responsibility of clinical documents and provide clinical documents as requested. The clinical director submits that a designated successor to be custodian of clinical files will be appointed in a reasonable time. 

     


    Sliding Scale Fees for Services Agreement Information:

     

    • Wellness Solutions, LLC provides sliding scale outpatient mental health services to individuals who meet the following criteria:

     

    • Individuals who do not have insurance benefits. Individuals who have insurance benefits that are out-of-network for Wellness Solutions, LLC. Individuals who meet one of the above criteria and also express to Wellness Solutions, LLC that without discounted services they would not be able to receive services. Wellness Solutions, LLC provides sliding scale rates to individuals who request sliding scale rates. Wellness Solutions, LLC does not complete financial investigations to make a determination of offering sliding scale rates. 

     

    • Individuals who would like to receive Wellness Solutions, LLC sliding scale discounted rate should be aware of the following: 

     

    • Wellness Solutions, LLC offers sliding scale rates based on the availability and needs of the requested clinical services as well as other factors and does not guarantee sliding scale services to any one. 

     

    • Wellness Solutions, LLS is not obligated to provide sliding scale services and does so to meet the needs of those in the community who may not otherwise be able to access services. 

     

    • Wellness Solutions, LLC reserves the right to rescind sliding scale rates at any time and for any reason. 

     

    • Clients who receive sliding scale rates may opt to change to pay for the full fees for service or to use new insurance benefits as appropriate. 

     

    • Wellness Solutions, LLC does not offer sliding scale rates to individuals with insurance through a company/policy from which Wellness Solutions, LLC is an in-network provider. 

     

    • Wellness Solutions, LLC sliding scale rates are limited ONLY to specific clinical services, such as, individual, couples, and family first session and subsequent session counseling and psychotherapy. ALL other Wellness Solutions, LLC fees for services remain the same for all clients. 

     

    • Wellness Solutions, LLC fees for Case Management & Coordination of Care, as well as,  Wellness Solutions, LLC fees for any and all services deemed necessary by Wellness Solutions, LLC. 

     


    Patient Account Information & Receipts for Services:

     

    • WS provides receipts via email every time a client’s credit card on file is charged. 
      Clients are also provided with an account summary at the end of every month via email if there is a balance on the account. 

     

    Clients are Responsible to Know Their Own Insurance Benefits: 

    • Clients pay their insurance company to manage their benefits, answer their questions about their benefits, and keep track of their claims information. If clients have questions regarding their insurance then the client should contact their insurance company to obtain this information. 

     

    • Wellness Solutions, LLC is not responsible for knowing a client’s insurance benefits better than the client. 

     

    • Clients who have questions about their insurance or complaints about their insurance should direct those questions and complaints to the appropriate party - their insurance company.  

     

    • Many clients have insurance benefits that include a mental health carve-out. A mental health carve-out is when the client’s mental and behavioral health benefits are managed by a different insurance company than the client’s medical benefits. This means that the client’s medical insurance is managed with one company and their mental health benefits are managed with a different company. The name of the mental health carve-out insurance company is usually NOT listed on the client’s insurance card. This can be confusing and complicated because if the client is not informed about his or her mental health carve-out then the client will provide insufficient information to WS regarding their insurance. This causes problems with insurance claims being rejected or denied. This also causes problems because in many situations the mental health carve-out insurance company is out of network. It is the client’s responsibility to inform WS if the client has a mental health carve-out. If the client has a mental health carve out the client is responsible for informing Wellness Solutions, LLC of the managed care company’s information so WS can bill the client’s insurance correctly.  

     


    Clients are responsible for Obtaining Employee Assistance Plan (EAP) Authorizations:

     

    • Wellness Solutions, LLC accepts a limited number of EAP insurance benefits. If a client wants to access his or her EAP benefits then the client is responsible for calling their insurance company, obtaining the EAP Authorization Number, the exact number of authorized sessions, and communicating that information to Wellness Solutions, LLC at the onset of care. 

     

    • The client will be asked to provide this information when completing the Wellness Solutions, LLC intake document(s).

     

    • Wellness Solutions, LLC does not contact insurance companies or EAP programs to obtain authorization numbers and the number of sessions covered. 

     

    • Wellness Solutions, LLC will submit EAP claims for clients for one treatment series only. 

     

    • Clients who have EAP benefits that can be renewed can only use those benefits with Wellness Solutions, LLC once. 

     


    Superbill Documentation Information: 

     

    • If a client opts to pay for the full fee for service and submit claims to his or her out-of-network insurance then Wellness Solutions, LLC will provide the required “superbill” documentation. The superbill will be provided no more than once per month.  To receive the superbill the client must request the documentation each month. Clients who opt for sliding scale are not eligible to submit their own claims to insurance and utilize out-of-network benefits.

     

    Clinical Documentation Notification: 

     

    • Please be informed that our practice utilizes AI-assisted scribe technology to document the content of clinical sessions. This technology is employed to ensure accuracy and efficiency in record-keeping while allowing the provider to focus fully on your care. The AI is designed to adhere to all relevant privacy regulations, including HIPAA, to protect your sensitive information. By signing this consent form, you acknowledge and agree to the use of AI scribe technology for documenting your clinical sessions. You also understand that this technology is utilized in compliance with current regulatory standards to enhance the quality and efficiency of your care.

     


    Consent for Counseling, Coaching, & Psychotherapy: 

     

    • By signing this document the client attests that the client read, agrees with, and will comply with all aspects of the Wellness Solutions, LLC Informed Consent & Disclosures. Further, the client provides consent to provide counseling, coaching, and psychotherapy to Wellness Solutions, LLC.  

     

    Money Matters: Acknowledgement & Consent:

    • With my signature below, I consent to Wellness Solutions, LLC accepting insurance payments and handling assignments from my insurance or third-party payors. I’m on board with Wellness Solutions, LLC checking my benefits, submitting claims, and doing what’s needed to get paid. I understand that I (or my guarantor) am responsible for all fees—whether my insurance covers them or not—and for any fees that come from rejected or denied claims. I understand that any extra fees Wellness Solutions, LLC incurs on my behalf or as a result of my care are my responsibility. I understand Wellness Solutions, LLC requires all clients to maintain a credit card on file and that my credit card will be charged for services and fees associated with my care. I understand a credit card on file is required to schedule an appointment and to receive services. I understand that a credit card on file is required for all clients regardless of using insurance or Employee Assistance Plan (EAP) benefits and having a zero patient responsibility (no copay or no coinsurance). By signing, I give Wellness Solutions, LLC permission to charge my credit card on file for any and all fees owed. I confirm that I’m authorized to approve these charges and agree to take responsibility for all service costs.

     

    Disclaimer:

     

    • Wellness Solutions, LLC reserves the right to change any/all policies, procedures, or information contained here in, including but not limited to the Notice of Privacy Practicies (NOPP), Client Rights, Responsibilities, and Expectations, and Client Informed Consent and Disclaimers. 

     

    End of Wellness Solutions, LLC Informed Consent & Disclosures

     

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    What Happens Next? 

    • Once you click on the "Submit" button you will see a "Thank You" confirmation page to verify we received your completed New Client Intake Form. 

     

    • You will also receive emails to confirm receipt of the New Client Intake Form and to provide information on the next steps of the intake process. 

     

    • We are hard at work reviewing your information to get you scheduled as quckly and easily as possible.

     

    • We will be reaching out within 2 business day to provide you with support, provide the result of your insurance benefits check (if applicable), and get you scheduled ASAP.

     

    • We will make every effort to accommodate all your preferences for care and we will also provide you with all of the available scheduling options available.

     

    • We will also send you a secure encrypted link to the STRIPE credit card on file form. The credit card on file must be completed to schedule an appointment. 

     

    • PLEASE make sure to be on the look out for helpful emails to keep you informed and updated throughout the care process. All Wellness Solutions emails will begin with WS in the subject of the email and will come from an email with the @wellnesssolutionsllc.com domain. If you have not received any emails please check your spam folder. 

     

    • Congrats and thank you for completing the Wellness Solutions New Client Intake Form! We are very grateful to be on this journey with you and look forward to helping you achieve your goals. 

     

    • If you have any questions please do not hesitate to reach out. We are here to help! 
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