Practice Policies

The forms below are available to review prior to starting therapy. It may be viewed by clicking on the hyperlinks below. The Practice has a partnership with Headway, who manages the billing if you’re in network with commercial insurance.
- Privacy Practice Policies: https://headway.co/legal/terms
- Assessment of Benefits/Financial Responsibility/Telehealth Consent: https://headway.co/legal/responsibility
If you plan to pay out-of-pocket, or is from a separate referral source, forms for consent to treatment, practice policies, telehealth consent will provided to you through Simple Practice portal.
Although the information you disclose to your therapist is confidential, there are limitations of client held privilege of confidentiality that you should be aware of.
- If a client threatens or attempts to commit suicide or otherwise conducts themselves 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.