LEGAL

Privacy Policy and Online Legal Matters

AGREEMENT FOR ON/OFFLINE PSYCHOTHERAPY SERVICES 

Notice of Privacy Practices and it is subject to HIPAA pre-emptive analysis. (Revised 1/05)

Confidentiality: All information disclosed within sessions and the written records pertaining to those sessions are confidential and may not be revealed to anyone without your written permission, except where disclosure is required by law. When Disclosure Is Required By Law: Some of the circumstances where disclosure is required by the law are: where there is a reasonable suspicion of child, dependent or elder abuse or neglect; where a client presents a danger to self, to others, to property, or is gravely disabled or when your family members communicate to your therapist, Ms. Leonhardt, that the client presents a danger to others. When Disclosure May Be Required: Disclosure may be required pursuant to a legal proceeding by or against you. If you place your mental status at issue in litigation initiated by you, the defendant may have the right to obtain the psychotherapy records and/or testimony from Ms. Leonhardt. In couple and family therapy, or when different family members are seen individually, even over a period of time, confidentiality and privilege do not apply between the couple or among family members, unless otherwise agreed upon. Ms. Leonhardt will use her clinical judgment when revealing such information. Ms. Leonhardt will not release records to any outside party unless he is authorized to do so by all adult family members who were part of the treatment. Emergencies: If there is an emergency during our work together, or in the future after termination where Ms. Leonhardt becomes concerned about your personal safety, the possibility of you injuring someone else, or about you receiving proper psychiatric care, she will do whatever she can within the limits of the law, to prevent you from injuring yourself or others and to ensure that you receive the proper medical care. For this purpose, she may also contact the person whose name you have provided on the biographical sheet. Litigation Limitation: Due to the nature of the therapeutic process and the fact that it often involves making a full disclosure with regard to many matters which may be of a confidential nature, it is agreed that should there be legal proceedings (such as, but not limited to divorce and custody disputes, injuries, lawsuits, etc..), neither you (client) nor your attorney's, nor anyone else acting on your behalf will call on Ms. Leonhardt to testify in court or at any other proceeding, nor will a disclosure of the psychotherapy records be requested unless otherwise agreed upon. Consultation: Ms. Leonhardt consults regularly with other professionals regarding her clients; however, client's identity remains completely anonymous, and confidentiality is fully maintained. Termination: As set forth above, after the first couple of meetings, the therapist will assess if she can be of benefit to you. Melissa Leonhardt does not accept clients who, in her opinion, she cannot help. In such a case, she will give you a number of referrals who you can contact. If at any point during psychotherapy Ms. Leonhardt assesses that she is not effective in helping you reach the therapeutic goals, she is obligated to discuss it with you and, if appropriate, to terminate treatment. In such a case, she would give you a number of referrals that may be of assistance to you. If you request it and authorize it in writing, Ms. Leonhardt will talk to the psychotherapist of your choice in order to help with the transition. If at any time you want another professional opinion or wish to consult with another therapist, Ms. Leonhardt will assist you in finding someone qualified, and if she has your written consent, she will provide her or him with the essential information needed. You have the right to terminate therapy at any time. If you choose to do so, Ms. Leonhardt will offer to provide you with names of other qualified professionals whose services you might prefer. CANCELLATION: Since the scheduling of an appointment involves the reservation of time specifically for you, a minimum of 24 hours (1 day) notice is required for re-scheduling or canceling an appointment. Unless we reach a different agreement, the full fee will be charged for sessions missed without such notification.

If you continue on you are saying that you have read the above Agreement, Informed Consent, Office Policies and General Information carefully, understand them and agree to comply fully with them.

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