Last Updated: September 18, 2024
By engaging in psychotherapy services with Dr. Daria Chase, PhD, you acknowledge that you have read, understood, and agree to the following terms and conditions.
1. Therapeutic Relationship
Psychotherapy is a collaborative process where the therapist and client work together to address emotional, psychological, and behavioral concerns. The client understands that the therapeutic relationship is professional in nature, and any advice or suggestions given are not guarantees of specific outcomes.
2. Confidentiality
All communications between the client and therapist are confidential unless:
- The client gives explicit permission to release specific information.
- The therapist is required by law to disclose information (e.g., in cases of abuse, threats of harm to oneself or others).
- The therapist is subpoenaed by a court of law.
Electronic communications (e.g., emails and text messages) are subject to privacy limitations, and the client should be aware of potential risks.
3. Appointments and Cancellations
Appointments are scheduled in advance and are typically [45-60] minutes long. Clients are expected to arrive on time. If you need to cancel or reschedule an appointment, please provide at least 48 hours notice. Missed appointments or late cancellations will incur a full fee.
4. Fees and Payment
Fees are determined during the initial consultation depending on the type of service and duration of the session. You can check the Fees section in order to get idea of what is customary charged. Payment is due upon reception of the super bill ant the end of each month unless other arrangements are made. Accepted forms of payment include Venmo, PayPal, Zelle. Outstanding balances may result in suspension of services. For clients using insurance, it is the client’s responsibility to confirm coverage and eligibility. Any co-payments, deductibles, or non-covered services are the client’s responsibility.
5. Telehealth Services
For clients receiving services via telehealth, both therapist and client agree to the following:
- Both parties will ensure that the telehealth environment is private and secure.
- Clients agree to participate in sessions in a stable environment free from distractions.
6. Informed Consent and Risks
The client may discontinue therapy at any time but is encouraged to discuss any decisions to terminate with the therapist to ensure a proper conclusion to therapy.
7. Crisis and Emergency Services
Dr. Daria Chase does not provide 24-hour crisis services. In case of an emergency or if the client feels they are in immediate danger, they should contact local emergency services, hotlines, or the nearest hospital.
8. Termination of Services
The therapeutic relationship may be terminated by the client or therapist. Reasons for termination by the therapist may include, but are not limited to:
- Non-payment of fees.
- Lack of progress after reasonable efforts.
- Behavior that jeopardizes the safety or effectiveness of the therapy.
- Ethical or legal conflicts.
In such cases, the therapist will provide referrals for continued care if appropriate.
9. Record-Keeping and Data Protection
The therapist maintains records of sessions and treatment plans to ensure continuity of care. These records are kept confidential and in accordance with HIPAA guidelines. Clients may request access to their records under certain conditions, as governed by law.
10. Client Responsibilities
Clients are expected to:
- Engage in the therapeutic process with openness and honesty.
- Provide accurate and complete information during assessments and sessions.
- Adhere to the agreed-upon scheduling and payment policies.
- Respect the boundaries of the therapeutic relationship.
11. Modifications to Terms
These terms and conditions may be updated periodically. Clients will be informed of any substantial changes in writing.
12. Governing Law
These terms and conditions shall be governed by and construed in accordance with the laws of the State of New York, including, but not limited to, the New York Education Law (Article 153), regulations of the New York State Education Department Office of the Professions, and applicable federal laws such as HIPAA. These terms and conditions shall also be governed by and construed in accordance with the laws of the State of Florida, including, but not limited to, the Florida Telehealth Act (Florida Statutes Chapter 456, Section 47), Florida Administrative Code for Psychologists (Rule 64B19).
