As you begin your counseling, there are a few items of information that you need to know. If at any time you have further questions, you may discuss them with your counselor.
1. Your fee is based upon a sliding fee scale that is based on your family’s gross income. Your counselor will retain the right to assess your financial status and personal considerations and make fee adjustments that are fair to both you and your counselor.
2. Payment of fees will be made in accordance with the financial policy. A written copy of this financial policy will be explained to you.
3. Your fee per session had been established at $
Your counselor will receive your payment at each session. Any questions about changes in fees should be discussed with your counselor.
4. If you find it necessary to cancel an appointment, you will need to call your counselor at least 24 hours in advance. Otherwise you will be charged for your session. This arrangement allows your counselor to make this time available to someone else if you are unable to use it. Persons having appointments on Monday will not be charged if you call by 9:00 am on Monday.
5. Your counselor reserves the right to consult with other counselors and/or supervisors about individual cases. This right may be waived if requested by you in writing.
6. In the unlikely event that you would want “out of office” or externally requested services from your counselor, it may be helpful for you to know the following.
• The cost of receiving a written report is $100. The report will be released upon receipt of payment.
• Externally requested consultation services are charged at a rate of $100/hour. If a court appearance is requested, a minimum of four (4) hours ($400) will be required. This fee must be paid and received in the office 24 hours before going to court. Additional hours will be billed to the client upon completion of the hearing. In the event the court hearing is canceled and cliets can be scheduled during the previously reserved hours, the money will be refunded.
7. All client records (all client-counselor contact) are held confidential and are the property of your counselor.
