Enrollment Agreement

Welcome to Speak Up & Stay S.T.R.O.N.G.!

Thank you for registering. Before your family begins the course, please review and sign this agreement. This document (the “Agreement”) contains important legal information about my nonclinical services and business policies. Before participating in my classes or trainings, it is important that you review and acknowledge this information. Please read it carefully, and let me know if you have any questions! 

Estimated time: 5 minutes

Course Description

Speak Up and Stay S.T.R.O.N.G. is a five-week educational program. It is an online class for children and their parents to attend together.

 

Class Format:

 Weekly online sessions occur via Zoom (60 minutes each).

• Children attend with their Parents for the first four sessions. Parents are required to attend all sessions with their child for the entire hour.
• Parents attend without children during the fifth session.
• Home practice assignments are provided via Google Classroom.
• The didactics portion of each session will be recorded for you to access during the course in case you have to miss a class.
   

 Class Structure:

The first four sessions include:

• A brief review of home practice (starting with the second session).
• A 15-minute instructional segment.
• Interactive activities such as games and role-play for children and parents to practice skills.
   

The fifth and final session for parents includes:

• Information on how to support your child's continued progress at home.
• Q&A: Troubleshooting tricky communication challenges at home.

Parent Responsibilities

Parents play a critical role in reinforcing their child’s learning. The program will provide you with strategies to support your child’s practice of the skills taught in class. This collaboration is essential because children often require guidance to apply new skills effectively in real-life situations.

Parent-child dyads will be given an opportunity to make a plan about when your child will try the skills and how you will prompt, support, and reinforce your child for trying. The iThrive Speak Up and Get Along course will also offer your strategies for how to provide that support.

Pre- and Post-Program Questionnaires

Speak Up and Stay S.T.R.O.N.G. is grounded in psychological science and strives to be both engaging and effective. As part of the commitment to demonstrating effectiveness, there will be questionnaires for parents and children to complete at the beginning and end of the program. These are used to evaluate the program’s impact and improve future offerings.

Financial Information

Professional Fees:

Tuition is due in full at the time of registration to reserve your family's place in the course. The tuition amount will be the price in effect at the time of registration.

Of the total tuition, $100 is a nonrefundable registration fee that reserves your family's place in this limited-enrollment program.

 

Cancellation Policy:

Because enrollment is limited and each family's participation contributes to the group experience, your registration reserves a place that may not be possible to fill if canceled.

 

If you cancel 21 or more days before the course begins, you may choose either:

1) A refund of the tuition paid, less a $100 nonrefundable registration fee, or

2) Course credit equal to the tuition paid, which may be applied toward a future Speak Up course offered within 12 months of the original course start date.

If you cancel fewer than 21 days before the course begins, you will receive:

• Course credit equal to the tuition paid, which may be applied toward a future Speak Up course offered within 12 months of the original course start date, less the $100 nonrefundable registration fee.
   

Insurance Reimbursement:

As this is an educational program, it is not eligible for insurance reimbursement.

Professional Privacy

I strive to keep the details and content of our group sessions private at all times.  However, as an educational class, the legal rules of confidentiality for healthcare information will not apply to our relationship. In addition, we cannot create a clinician/client relationship and the rules of privilege will not apply.  I am 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.

Video Recording of Classes

The didactic portion of each class will be recorded and made available for families during the course. Activities, role plays and Q&A sessions will not be recorded.

Participants are prohibited from recording any part of the course. By signing this Agreement, you agree not to record any portion of the program.

Distribution of Content

The program materials are the intellectual property of Leah Altemeier, Ph.D. Unauthorized distribution, reproduction, or sharing of these materials for business purposes is prohibited. For personal use (e.g., sharing with a family member or caregiver), please request prior permission from Dr. Altemeier.

Provider Information

My Education, Training, and Licensure

I have a Ph.D. in Educational Psychology from the University of Washington. I completed my predoctoral internship at the University of Washington Center on Human Development and Disability, and Seattle Children’s Hospital and Regional Medical Center. I am a licensed psychologist in the state of Washington (#PY00003695). “Licensure” means that I have a doctoral degree from an accredited university and have passed a national written examination and an oral examination given by the Washington State Examining Board of Psychology. While my professional background informs this program, Speak Up and Stay S.T.R.O.N.G. is strictly an educational service.

Contacting Me

Due to my schedule, I am not immediately available by telephone. Therefore, I am not able to provide on-call crisis care. If you think that you may need this level of support, it is important that you let me know so that we can determine whether I am an appropriate provider for you, if you need additional providers, and/or if we need to develop a crisis plan for you. Leaving a message on my voicemail or email is the only way to reach me. I am typically able to return messages on Tuesdays, Wednesdays, and Fridays.

 

If you’d like to establish a clinical relationship with me at the conclusion of the program, please reach out to me. I will have you sign a separate Professional Services Agreement for clinical services.

By signing below, I acknowledge that:

• I have read and understand this Agreement.
• I have read Leah Altemeier's Privacy Policy for this class.
• I understand that Speak Up and Stay S.T.R.O.N.G. is an educational program and not psychotherapy or a clinical service.
• I voluntarily agree to participate under the terms described above.
• I am the child's parent or legal guardian and have the legal authority to consent to my child's participation.