Fees:  Payments are due at the time services are rendered; payment will be received at the beginning of each session.  It is up to the discretion of the therapist to allow for a deferred payment. I accept cash and checks only. For more information on rates select "Rates & Insurance" tab.

Emergencies:  I do not provide formal emergency services, yet I wish to be as available as much as is reasonably possible.  You may call the office number at any time and leave a message if I do not answer.  During the business day I can often, though not always, return calls fairly quickly.  Nighttime and weekend calls will usually be returned the next business day.  If you find yourself in an urgent situation, make a judgment about the prudence of waiting for my call versus calling 911 or going to the nearest emergency room for immediate care.  If I am away for more than a day, my voice mail message will indicate that and state my expected date of return.

Death or Incapacity: In the event that the therapist dies or is otherwise incapable of providing for the clinical services of this office the patient consents for the therapist to designate Janet Douglas, LCSW as conservator for the records of this office, including all patient records, and at the time of death or incapacity of the therapist she will take possession of the patient records and make those available to the patient or a mental health professional of the patient’s choosing at such time that a written request I made to this office.

Accounts:  Payment may be made with cash or by check.  I do not extend credit.  In any such arrangement, late payment fees of $10 per month will be charged on any balance not paid within 30 days.  I do not depend on an outside collection service unless accounts are overdue by 90 days.  I would much rather communicate with patients and find some solution to overdue accounts.  Patient hereby consents to the delegation of collection activities to an outside collection agency, including the release of necessary information required by the collection agency.  A delinquency fee of 40% of the outstanding balance will be added if a collection agency is required.  There is a returned check processing fee of $25 in addition to reimbursement for charges assessed by my bank.  Statement, receipts or other documentation will not be issued to any delinquent account until paid in full. 

Missed appointments:  Unless waived by mutual agreement on a case-by-case basis, no-shows and cancellations will be charged for unless you cancel at least 24 hours in advance of the appointment time.  The fee for late cancellations (less than 24 hours notice) or no-shows is $50.00.  Patients arriving 15 minutes or more late to the appointment will be considered a no-show and must be rescheduled unless other arrangements are made with the therapist.  Patient understands the appointment policies of the office and assumes responsibility for payment of fees related to late cancellations or no-show appointments. Such charges are payable immediately.

Credit Card Authorization for Late Cancellations and No-Shows: Authorization is given to charge credit/debit cards for late or no-show appointment fees when incurred.  Patient understands the appointment policies of the office and assumes responsibility for payment of fees related to late cancellations or no-show appointments.  Such charges are payable immediately and will be automatically deducted, where applicable, and are not normally reimbursable by insurance.

Upon your first visit, you will be asked to sign a statement agreeing to policy of Country Day Counseling for late cancellations and no-show fees. You will be asked to give your credit/debit card information for reasons stated above. This information will be for the sole purpose of collecting no-show and late cancellation fees and will not be used at any other time.