Peace Full Living Client Policies

Appointments: Sessions are scheduled by appointment and are 70′ long for couples and 50′ for individuals. Your appointment time is reserved exclusively for you and cannot be rescheduled on short notice. Missed appointments or those not canceled at least 48 hours in advance may be billed for the entire amount of the session. Late cancellations due to medical or other emergencies will not be considered as missed appointments. I am available for phone calls between sessions if needed.  Calls longer than 15 minutes will require a scheduled appointment and will be pro-rated at the regular fee rate.

Couples are usually seen together, with several individual sessions used as part of moving the work forward. Please note that I cannot hold secrets from your partner, but I can help you tell them things you might be afraid to tell them.

Credentials: I hold a Master’s Degree in Spiritual Psychology, am certified in Imago Relationship Therapy, have advanced training in Emotionally Focused Therapy as well as numerous other professional trainings.  Oregon does not recognize my master’s level training for licensure at this time. I abide by all the state laws and ethics, continuing education and liability/malpractice insurance requirements. I also maintain firm principles of integrity and respect for all. If you are not comfortable with my current licensure status, I am happy to provide an appropriate referral.

Fees: My current fees are: $110 for couples, and $85 for individuals. I also offer extended sessions of 90′ for $150 and $125. If these fees will prove to be a financial hardship on you, please inquire about a more manageable fee.  I have a limited number of sliding scale slots available.

Payment & Billing Policy: You are responsible for payment (cash, check, money order, debit or credit card) for all services at the start of service unless a payment plan has been arranged. Insurance is not accepted at this time. If collections become necessary you will be responsible for all fees incurred, including legal or other professional services required to obtain full payment.

Confidentiality: Communication between a counselor and clients is strictly confidential. You must sign a release of information before any personal information can be shared with other individuals or agencies. Information may be released without your written consent only under the following legal or ethical circumstances, as outlined by law:

* When a court order is received for records or testimony.
* In the case of apparent, suspected or potential child or elder abuse/neglect.
* When clients report sexual abuse by a regulated health care professional.
* If a client indicates that s/he or another person may be a danger to his/herself or others.

Emergencies: If you are having an emergency, and need to talk to someone immediately, call 911 or one of the crisis lines listed below. If you feel you cannot keep yourself safe, go to your health plan facility Emergency Room for psychiatric evaluation.

I have read and agree to abide by the policies outlined above.
I have received a copy for my personal records.

Signature:________________________________________ Date:______________

Signature:________________________________________ Date:______________

 

Crisis Lines:

Multnomah County Mental Health (24 hrs): 503-215-7082
Clackamas County Mental Health: 503-655-8401
Washington County Mental Health: 503-291-9111

Portland Women’s 24/7 Crisis Line: 503-235-5333

OR Suicide & Crisis 24/7 Hotline: 503-988-4888 or 800-716-9769
Suicide Prevention Hotline: 800-422-7558

OR Child Abuse Hotline (24 hrs): 503-731-3100
Crisis Hotline for Youth & Families: 800-999-9999

Senior Helpline (24 hrs): 503-248-3646
Elder Abuse Hotline: 800-232-3020

Alcohol & Drug Helpline: 877-553-8336