APPOINTMENTS AND CANCELLATIONS:
Please remember to cancel or reschedule 24 hours in advance. You will be responsible for the entire fee if cancellation is less than 24 hours.
The standard meeting time for psychotherapy is 50 minutes. It is up to you, however, to determine the length of time of your sessions. Requests to change the 50-minute session needs to be discussed with the therapist in order for time to be scheduled in advance.
A $10.00 service charge will be charged for any checks returned for any reason for special handling.
Cancellations and re-scheduled session will be subject to a full charge if NOT RECEIVED AT LEAST 24 HOURS IN ADVANCE. This is necessary because a time commitment is made to you and is held exclusively for you. If you are late for a session, you may lose some of that session time. Please know that exceptions to this policy may be made in the instance of serious medical emergency or serious family emergency.
FEES AND PAYMENT:
Ashley Cook-Rovira, PLLC is considered an “out-of-network” provider. This means that I will provide you with a super-bill at your request to submit to your insurance company if you wish to file for reimbursement provided by your out-of-network benefits. I do not accept insurance directly. I accept payment via check, cash, or credit/debit card. Payment is due at the time of service.
AFTER HOURS POLICY AND EMERGENCIES:
My typical “office hours” are Monday-Thursday 8am-7pm. I request that you respect these hours and refrain from calling and/or texting outside of these hours. In regard to emergency situations, please understand that I will do everything to help in these situations. However, if you are a threat to yourself or others, it is your responsibility to contact 911 or contact your nearest emergency room. If you need to contact me between sessions, please leave a message on my voice mail or send a text if you are comfortable doing so. However, please understand that I cannot guarantee confidentiality when communicating via text or other electronic forms of communication. I am often not immediately available; however, I will attempt to return your call within 24 hours.
SOCIAL MEDIA AND TELECOMMUNICATION:
Due to the importance of your confidentiality and the importance of minimizing dual relationships, I do not accept friend or contact requests from current clients on any social networking site (Facebook, LinkedIn, etc). I believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up when we meet and we can talk more about it.
Please note that face-to-face sessions are highly preferable to phone sessions. However, in the event that you are out of town, sick or need additional support, phone sessions are available.
I cannot ensure the confidentiality of any form of communication through electronic media, including text messages. If you prefer to communicate via email or text messaging for issues regarding scheduling or cancellations, I will do so. While I may try to return messages in a timely manner, I cannot guarantee immediate response and request that you do not use these methods of communication to discuss therapeutic content and/or request assistance for emergencies.
Services by electronic means, including but not limited to telephone communication, the Internet, facsimile machines, and e-mail is considered telemedicine by the State of Texas.
In addition to your right to confidentiality, you have the right to end your therapy at any time, for whatever reason and without any obligation, with the exception of payment of fees for services already provided. You have the right to question any aspect of your treatment with your therapist. Ending relationships can be difficult. Therefore, it is important to have a termination process in order to achieve some closure. The appropriate length of the termination depends on the length and intensity of the treatment. I may terminate treatment after appropriate discussion with you and a termination process if I determine that the psychotherapy is not being effectively used or if you are in default on payment. I will not terminate the therapeutic relationship without first discussing and exploring the reasons and purpose of terminating. If therapy is terminated for any reason or you request another therapist, I will provide you with a list of qualified psychotherapists to treat you. You may also choose someone on your own or from another referral source.
Finally, I work hard to make sure that you have a positive therapy experience. However, if a conflict occurs, it is agreed that any disputes shall be negotiated directly between the parties. Should you fail to schedule an appointment for three consecutive weeks, unless other arrangements have been made in advance, for legal and ethical reasons, I must consider the professional relationship discontinued.
Communication between you and your therapist is confidential. This means that your therapist will not discuss your case orally or in writing without your expressed written permission.
Limitations of such client held privilege of confidentiality exist and are itemized below:
- If a client threatens or attempts to commit suicide or otherwise conducts him/her self in a manner in which there is a substantial risk of incurring serious bodily harm.
- If a client threatens grave bodily harm or death to another person.
- If the therapist has a reasonable suspicion that a client or other named victim is the perpetrator, observer of, or actual victim of physical, emotional or sexual abuse of children under the age of 18 years.
- Suspicions as stated above in the case of an elderly person who may be subjected to these abuses.
- Suspected neglect of the parties named in items #3 and # 4.
- If a court of law issues a legitimate subpoena for information stated on the subpoena.
- If a client is in therapy or being treated by order of a court of law, or if information is obtained for the purpose of rendering an expert’s report to an attorney.
The exceptions to confidentiality are also outlined in the “Texas Notice Form”, which you will be asked to read and sign. You may be given a copy of this form upon request.
If you are a minor, your parents may be legally entitled to some information about your therapy. I will discuss with you and your parents what information is appropriate for them to receive and which issues are more appropriately kept confidential.