Practice Policies and Financial Responsibility Agreement

Appointments and Cancellations 

Psychotherapy sessions are scheduled for 53 minutes. Please cancel or reschedule at least 24 hours in advance. Appointments canceled with less than 24 hours’ notice or missed without notice will incur a $75 fee. If you are late for a session, the session will still end at the scheduled time.

Payment of Fees 

You agree to pay charges for services as described in this agreement. Unless otherwise arranged, payment is due after each session and will be charged to your debit/credit card or via ACH transfer. Receipts may be provided at the time of charge or monthly. Missed appointments or late cancellations are not billable to insurance and are your responsibility.

Insurance and Managed Care Plans 

If Well Counseling Group, LLC is in-network with your insurance plan, you agree to pay any required deductibles, co-payments, co-insurances, or other forms of cost-sharing. If your insurance coverage ends or is denied, you will be responsible for all charges. Estimated costs are due at the time of service.

Assignment of Benefits and Release of Information

You authorize your insurance plan to make payments directly to Well Counseling Group, LLC. You also authorize us to release any information necessary to obtain insurance benefits and service authorizations. Any exceptions to this must be provided in writing.

Telephone Accessibility 

If you need to contact your therapist between sessions, please text or leave a voicemail. While immediate response is not guaranteed, we strive to respond within 24 hours. For emergencies, call 911 or go to the nearest emergency room.

Social Media and Communication Boundaries 

To protect your confidentiality and our therapeutic relationship, we do not accept social media friend or contact requests from clients. This helps maintain professional boundaries and privacy.

Electronic Communication 

Electronic communications (e.g., texts, emails) may not be secure. You may use them for administrative matters like scheduling or cancellations, but please avoid discussing therapeutic content via these methods. We do not guarantee immediate responses.

Minors

If you are a minor, your parent or guardian may have legal rights to your treatment information. We will discuss with you and your parent(s) what information may be shared while honoring your confidentiality as much as possible.

Termination

Therapy may conclude when goals are met, or if therapy is no longer beneficial. If you wish to stop therapy or switch providers, we can offer referrals. If you miss three consecutive appointments without prior arrangement, we will consider the professional relationship terminated.

By signing below, you confirm your understanding and acceptance of these terms.