Clinical Evaluation for an Immigration Case:
-The fee for the evaluation includes the written report, as well as the time spent with Miguel Corzo, LCSW in interviewing sessions.
-Additional fees apply when the report is time-sensitive.
-Additional fees apply for any court appearances by Miguel Corzo, LCSW.
Total fees for these services = $500
* Credit Cards, Checks and Cash accepted; Fees are due at the beginning of the first session.
* Please note: Once a session is scheduled, at least 24 hours’ notice is needed to cancel or reschedule the appointment. A $50 charge will be added to the client’s bill for any missed appointments or cancelations made with less than 24 hours’ notice.
Radical Elevation is not responsible for the outcome of any legal proceedings for which the assessment is submitted. She is committed to transcribing the client’s words as accurately as possible; however, she is not liable for any information written in the document that differs from the client’s testimony, statement, affidavit or any other communication. Radical Elevation is able to void this contract at any time for any reason, without prior notification, including in instances involving but not limited to client nonpayment and instances in which she concludes that the client is lying/malingering. In this type of instance (if the report has not already been completed), the client will be given the option of cancelling the report and paying solely for the time that Radical Elevation has already spent meeting with the client and/or working on the assessment.
Although clinical assessments may provide some therapeutic benefits, they are not therapy. Individuals may benefit from ongoing therapeutic treatment. Every effort will be made to minimize an individual’s discomfort during the assessment; however, an individual may experience distress and difficulties pertaining to the material discussed. Whenever a client is experiencing severe symptoms of anxiety or depression, it is strongly urged that the client seek out therapeutic treatment from a licensed therapist and/or psychiatrist. If a client is experiencing serious thoughts of harming themselves or others, it is strongly urged that the client call 911 or go to the nearest emergency room.
Additionally, all information provided during the assessment will be held confidential, except for the written report which will be given to the client and his or her lawyer. Other exceptions to confidentiality are in instances when the therapist is worried that the client is a danger to him/herself or to someone else; the therapist is concerned about the abuse or neglect of a child, elder or vulnerable person; there is a court order for a release of records; or when the client has signed a release of information form for an individual or agency.
As the client of Radical Elevation: I agree for her to speak freely with my attorney and staff; to share and receive all information relating to my case, including information related to mental health treatment, substance use, and any medical issues, illnesses, communicable diseases such as HIV and other medical conditions. If I want to restrict information that Radical Elevation and my lawyer speak about, I will not sign below but instead talk with Radical Elevation to construct a new contract detailing the restricted information.
I also agree to meet with Radical Elevation over internet-based video/audio conferencing software, as well as communicate via text message and email, and I agree to whatever risks of confidentiality may occur through these mediums. I understand that audio/video recording devices may be utilized during the session and that I have the right to request that all recording devices stop recording at any time. I understand that these recordings are to assist with documentation processes and that all records of such recording are deleted promptly after all documentation is generated or within 30 days of the last interview. I understand that the generation and electronic storage of records may utilize artificial intelligent software and that all software employed by Radical Elevation have a Business Associate Agreement (BAA) to abide by and secure all personal identifying information and health care information in accordance with the Healthcare Insurance Portability and Accountability Act (HIPAA)