Office Polices for Gail Post, Ph.D.

Psychotherapy is a process involving collaboration, mutual trust and openness about expectations. In keeping with this, the following statement outlines my expectations and office policies. Please review this carefully.

 

Appointments: Most appointments occur on a weekly basis, although sometimes sessions are held more or less frequently. Appointments last 50 minutes. Your appointment time is held exclusively for you. If you know you will need to cancel, I ask that you inform me as soon as you are aware of this, so that I can make other arrangements. This also gives us greater flexibility in finding another appointment time for you. Except in cases of extreme emergencies, you will be charged for your time unless you provide at least 24 hours notice of cancellation. (Please note that insurance companies will not cover this charge, and you will have to pay the entire amount out of pocket.) In rare situations, a phone session may be used in place of our regular meeting. Frequent, repeated cancellations may result in a decision to end treatment.

 

Emergencies: I check my voice mail at least every few hours on weekdays up until 6:00 P.M., several times in the evenings, and several times a day on weekends. If you need immediate support before I am able to reach you, please contact Crisis Intervention Services at (610) 279-6100. You should contact 911 or go to your local hospital emergency room if you are at risk of self-harm.

 

Electronic Communication: Please avoid sending any confidential information through e-mail, since the internet is not a secure form of communication. Please contact me by phone rather than e-mail if you would like to reschedule a session. I do not communicate through Facebook or other social networking sites.

 

Fees: My fee for professional services is $170.00 for a fifty minute session. If there is an increase in fees, you will be informed at least one month in advance. You will be charged for additional services provided at your request or for your benefit, such as report writing, consultation with other professionals, or phone calls lasting over ten minutes. Payment is requested in full at the time of your visit. If you are having trouble with your bill, please let me know so that we can discuss other possible payment arrangements. Ultimately, though, you are responsible for your bill, and if you do not pay, your account will be turned over to an attorney or collection agency.

 

CONSENT FOR PSYCHOTHERAPY

 

I understand that while psychotherapy offers many benefits, there are no guarantees about what will happen or whether it will result in the outcome I am seeking. Risks may include experiencing uncomfortable thoughts, feelings or memories, since the process of psychotherapy often requires discussing unpleasant topics. Sometimes people initially feel worse before they start to feel improvement.

 

I also realize that for therapy to be effective, I will have to play an active role and work on what we discuss outside of sessions.

 

If I have questions or concerns about therapy, I will contact Dr. Post and discuss them directly.

 

I agree to openly discuss any worsening of symptoms with Dr. Post. I also understand that if I am experiencing a life-threatening crisis, I need to call 911 or go to the Emergency Room of my local hospital, as outlined in the Office Policies section.

 

I agree to honor any financial obligations, including any fees charged for cancellations that occur without 24 hours notice, as outlined in the Office Policies section.

------------------------------------------------------------------------------------------------------------

 

Your signature below indicates that you have read the Consent, Office Policies, and the Notice of Privacy Practices and agree to their terms.

 

_________________________________________

Printed Name of Patient or Personal Representative

 

_________________________________________

Signature of Patient or Personal Representative

 

_________________________________________

Signature of Parent or Guardian

 

Date ____________________________________