Information for Clients
Finley Terhune, LMFT 112607
Fees and Insurance:
Fees are to be paid at each session. If you have insurance which includes a copay or coinsurance, that fee is due at each session. I am also happy to assist you in determining the coverage your insurance may provide, as well as providing receipt(s) upon request.
You will be responsible for paying the full fee per session, at the time of session.
48 hours notice is required for canceling an appointment. The full fee will be charged for sessions with less than 48 hours notice for cancellation, or in the case of failure to arrive for a scheduled session without contacting me.
If you are using insurance, and cancel in less than 48 hours, or fail to arrive for a scheduled session, your insurance will not pay for the session. In this case, you become responsible for the entirety of the no show/late cancellation fee.
Cancellation Policy:
Your commitment to therapy is fundamental to your progress. Once we have agreed on a regular meeting time, you will be expected to manage your schedule so that you do not miss appointments. If you would like to change the frequency of sessions or terminate therapy, it is important that we discuss this together in session. Since scheduling of an appointment involves the reservation of time specifically for you, a minimum of 48 hours notice is required for cancelling an appointment. The full fee will be charged for sessions missed without such notification.
Confidentiality:
All information that you and I discuss is strictly confidential. No information will be released to anyone outside the therapeutic relationship without your authorization. The only exceptions to this professional agreement are:
1. If you threaten harm to yourself or to someone else. I am legally required to inform the police, the intended victims, and the person(s) whom I believe can provide immediate protection to you and/or the intended victim.
2. If during the course of therapy I have adequate reason to suspect child abuse/neglect (children under 18 years of age) or vulnerable adult abuse/neglect, I am legally required to report my suspicions to the appropriate authorities.
3. If you become involved in a legal proceeding and choose to waive the “privilege of confidentiality.”
4. In case of the Patriot Act, in which your records may be seized; this is the
only time I will be unable to inform you of the release of your records.
Phone Contacts:
You may contact me at any time for emergencies. I check my messages frequently and will return your call as soon as possible. If events arise between your therapy appointments that are particularly upsetting to you and you with to speak to me, please let me know and I will discuss the situation briefly by phone or set up a special office appointment to discuss it more in depth. If you are experiencing an emergency, please do not wait for a reply. Instead, call 911, a local emergency room, and/or individuals within your support network.
Informed Consent:
I do hereby consent to participate in therapy. I certify with my signature below that I have read, had explained to me where necessary, fully understand, and agree with the contents of this form.