Parent Coaching & Educational Consulting

Step 1: Choose your package! (You can always add additional services later, if you're unsure, start with the basic and we can help with the rest!) 

Step 2: For new clients, please schedule your first appointment. If you are a current SPT client, this step will be skipped. 

Step 3: Sign our consent forms.

Step 4: Provide your client information and reasons for seeking help.

Finalize: You will receive an email confirmation with your booking information upon receipt of this form.

Unsure about booking?!

Click here to browse schedule openings for the first appointment before purchasing the package. 

Please note: If you book an appointment without purchasing a package, you’ll have 24 hours from the time of booking to complete payment and paperwork. If payment and paperwork is not received within 24 hours, the appointment will be canceled. You’re welcome to rebook at any time.

CLICK HERE to schedule your first 50 min appointment. You will schedule the follow up appointments later.

* Don't see a time you like? Skip this, and we'll reach out to schedule.

 

Please note: We will give a 24-hour grace period from the time of when the appointment was booked to receive the completed payment and paperwork.

e.g. If you booked an appointment at 12pm today, you will have until 12pm tomorrow to complete the payment and paperwork in this form.

If the completed payment and paperwork has not been received within the 24-hour grace period, we will cancel the booked appointment. Rebookings are welcomed if your appointment was canceled.

Educational Consulting & Parent Coaching Informed Consent

Introduction

This document is an agreement between you and Seattle Play Therapy, PLLC to provide you with information and scope for Educational Consulting and Parent Coaching. 

Scope

Parent Coaching provides short-term structured, goal-focused sessions to increase parenting strategies and confidence while enhancing parent-child relationships. 

Educational Consulting provides support to parent and schools around supporting the family’s social, emotional and behavioral needs in educational settings. 

While our consultants may also be trained in mental health and be licensed counselors or therapists, both Educational Consulting and Parent Coaching is a consultation and coaching service. These services are NOT a health care service or counseling or psychotherapy and should NOT be considered a replacement for any health care service of any kind.

Educational Consulting or Parent Coaching are not designed to replace counseling or therapy by a licensed professional. Educational Consulting and Parent Coaching do not address mental health diagnoses, safety risks or severe anxiety. Some families may not be a good fit for Parent Coaching, in which case your consultant will provide you with appropriate referral resources. 

Approach

Consultation and Coaching sessions, you can share your concerns about your child and your struggles as parents or struggles in the school context. Your consultant will listen carefully to your concerns and provide you with information and resources. Your consultant will also provide you with developmentally appropriate and neurobiologically informed parenting tools, strategies, books, websites, resources for further learning.

Appointments

Consultation and Coaching may be scheduled for either 25-minute or 50-minute sessions, depending on your needs and your consultant.

To maintain the boundaries and limitations of Educational Consulting and Parent Coaching, we limit coaching sessions to no more than 20 hours per year.
Appointments are scheduled for a mutually agreed upon time and take place via Zoom unless otherwise discussed.  

Cancellation Policy

Because your time is saved for you, we require a 48 hours’ notice if rescheduling is required. For situations in which 48-hours’ notice is not provided, you will not receive a refund. This is not meant to be punitive, but rather a respectful agreement of our time together. 

Any appointments paid in advance are not refundable if you choose not to continue with Parent Coaching for any reason.

Fees

Appointments are scheduled at either 25 minutes at the rate of $100 or 50 minutes at the rate of $200. All services are billed based on the time spent.

Generally, services are prepaid through our website, though you may store your credit card on file through Square to add on services as you request them. There are no refunds for pre-paid services, though we will attempt to reschedule if appointments are cancelled within the 48-hour window.

In the event that you purchase a package that includes an educational component, but the school does not, for whatever reason, participate in coordination with us, you will be offered alterative services, but no refund will be issued.

Upon request, we will provide you with a receipt for your services, but NOT a Superbill as this is not a health care service and therefore not reimbursable by insurance or Health Saving Accounts.

Privacy

We protect your privacy when meeting for Educational Consulting and Parent Coaching services. This means we generally do not share information shared with us with anyone outside of Seattle Play Therapy. However, the legal protections of confidentiality for healthcare information do not apply to Consulting and Coaching services.

Since our consultants are mandated reporters, we are required by law to disclose certain information including suspected abuse or neglect of children under RCW 26.44 or suspected abuse or neglect of vulnerable adults under RCW 74.34. Because Parent Coaching is not a health care service, the psychotherapist/client privilege does not apply.

 

Consent for Consulting and Coaching

By signing below and scheduling Consulting and Coaching sessions, you are attesting that you understand and agree to the contents of this document specifically to include the following highlighted points:

• that Consulting and Coaching does not guarantee success or definitive changed behavior.
• that Consulting and Coaching does not involve the diagnosis or treatment of mental health disorders.
• that Consulting and Coaching is not a substitute for counseling, psychotherapy, psychoanalysis, mental health care, or substance abuse treatment. Consulting and Coaching should not be used in place of any form of diagnosis, treatment, or therapy. 

Consent for Video (Optional)

Seattle Play Therapy would like to request your permission to video record our Parent Coaching sessions for education and teaching purposes. The video recordings will be stored securely according to HIPAA standards for client information.

I understand the following:

• The purpose of the recording is for educational and teaching purposes only. The video recording will not become part of my record.
• The video will be reviewed by my therapist, supervisors, consultation groups and those seeking educational training in counseling and psychology, including but not limited to, Bachelor’s or Master’s level case managers, counselors, therapists, and educators. Information Technology specialist may have access to these recordings.
• Video material will be destroyed upon retirement of the therapist, or closure of the business, whichever comes first.
• I may withdraw my consent to be recorded at any time.

By providing my electronic signature, I acknowledge that I have read and understand the terms applied to video consent and that my consent is entirely voluntary and will not impact my services in any way.

Consent for Educational Consulting and Communication with School

By signing below and scheduling Consulting and Coaching sessions, you are attesting that you understand and agree to the contents of this document specifically to include the following highlighted points:

• that Educational Consulting does not guarantee success or definitive changed behavior.
• that my child will be observed in the classroom setting.
• The day/time/length of the observation will be mutually determined between the school and the consultant.
• that it is possible the behaviors I am concerned about may not occur during the observation time allotted.
• that by signing here my consultant and my school can mutually exchange information related to my child's social/emotional and behavioral needs at school.

Release of Information (ROI)

I understand that I may request that my or my child's mental health provider at Seattle Play Therapy to disclose my private health care information to a third party. I understand that under Washington State law, my mental health provider may charge a reasonable fee for providing my health care information to a third party, and they are not required to honor my request or authorization until the fee is paid. I hereby request my mental health provider to disclose my private health information as specified below.

The information specified above will be disclosed to:

This authorization of disclosure of my health information will expire when treatment is terminated, unless otherwise indicated. I understand that if the disclosure is being made to a financial institution or to my employer for purposes other than payment, Washington State law requires this authorization to expire no later than one year after signing.  
 
I understand that my protected health information disclosed pursuant to this agreement may be subject to redisclosure by the recipient and in such cases may no longer be protected by state or federal rules of confidentiality. 
 
I understand that I have the right to refuse to sign this form for authorization to disclose or release my private health information and that my refusal to sign this authorization will not adversely affect my ability to receive health care services, nor will treatment, payment, enrollment or eligibility for benefits be conditioned on whether I sign this authorization. 
 
I understand that I may revoke this authorization in writing at any time. If I revoke this authorization, the information described may no longer be used or disclosed as described in this authorization unless action has already been taken in reliance on this authorization. 

This authorization is being made at my request.

I am aware that coordination with other providers will be billed to my account and is not billable to insurance. The charges are listed on the financial agreement section of the disclosure document.

Privacy Notice

Please note that the information you provide here becomes part of your official chart as soon as you become a client. If you would feel more comfortable sharing certain information with us verbally, please let us know.

This form is reviewed by a mandated reporter for child abuse or abuse of a vulnerable adult. For more information about mandatory reporting for child abuse, please visit the website for WA State Department of Child, Youth and Families.