Transparency & consent
Notices & disclosures.
Plain-language summaries of the notices we're required to share with clients — billing rights, privacy practices, and telehealth consent.
Good Faith Estimate & the No Surprises Act
Effective since January 1, 2022
Under Section 2799B-6 of the Public Health Service Act, health care providers are required to give patients who don’t have insurance, or who are not using insurance, an estimate of expected charges for services before care begins.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services, including psychotherapy services. You can ask your provider, or any provider you choose, for a Good Faith Estimate before you schedule a service, or at any time during care.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill. Make sure to save a copy of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit cms.gov/nosurprises or call 1-800-985-3059.
HIPAA Notice of Privacy Practices
Summary — full notice provided at intake
This notice describes how your medical and mental health information may be used and disclosed, and how you can access this information. Please review it carefully.
In general, we use and disclose your protected health information (PHI) only as necessary to provide treatment, obtain payment, and conduct routine healthcare operations. We will not share your information for any other purpose without your written authorization, except where required or permitted by law (for example, to prevent serious harm to you or others, or in response to a valid legal order).
You have the right to request access to your records, request corrections, request a list of certain disclosures, request restrictions on how your information is used, request confidential communications, and receive a paper copy of the full privacy notice at any time.
Telehealth Consent
Basics — full consent reviewed and signed at intake
Telehealth allows you to receive counseling services remotely using secure, HIPAA-compliant video technology. By participating in telehealth sessions, you acknowledge and agree to the following:
Privacy: Please join sessions from a private, quiet location where you won’t be overheard, and use headphones where possible.
Technology: A stable internet connection is recommended. Occasional technical issues may interrupt a session; if we lose connection, we will attempt to reconnect or continue by phone.
Appropriateness: Telehealth is not appropriate for every situation, including some crisis or safety concerns — your clinician will discuss whether in-person care is recommended.
Emergencies: Telehealth is not a substitute for emergency services. If you are in crisis, call 911 or 988, or go to your nearest emergency room.