Office Policies and Consent Form:
Click on Office Policies and Consent Form to open the form and complete it on your computer. Then print it and bring it to your first visit.
My Policies and Consent Form contains the following contents:
The purpose of this document is to outline your rights and responsibilities as a client/patient of Dr. Steven Garman, as well as his rights and responsibilities to you. Please review this document very carefully and feel free to ask any questions or seek clarification from Dr. Garman about anything contained within this document. Please sign the last page of this document to indicate that you have read it in its entirety. You may print a copy of it, or if you prefer, Dr. Garman can provide one for you.
CONFIDENTIALITY AND PRIVACY
All information disclosed within therapy sessions and the written records pertaining to those sessions are confidential and may not be revealed to anyone without the client’s expressed permission, except where disclosure is required by law. There are a few exceptions under California law when disclosure is required:
- when there is a reasonable suspicion of child, dependent or elder abuse or neglect;
- when a client presents a danger to self, to others, to property, or is gravely disabled;
- when a client’s family members communicate to the client’s therapist that the client presents a danger to others.
These situations have rarely occurred in my practice. If such a situation occurs, I will make every effort to fully discuss it with you before taking any action.
A detailed explanation of The Health Insurance Portability and Accountability Act (HIPAA) as it applies to Dr. Garman’s practice can be found at www.drstevegarman.com or is available in printed form upon request.
Both the law and the standards of the psychology profession require that psychologists keep appropriate treatment records for at least 7 years. If you have concerns regarding the treatment records please discuss them with Dr. Garman. As a client, you have the right to review or receive a summary of your records at any time, except in limited legal or emergency circumstances or when Dr. Garman assesses that releasing such information might be harmful in any way. In such a case Dr. Garman will provide the records to an appropriate and legitimate mental health professional of your choice.
PAYMENT FOR SERVICES
The fee for a 45-50 minute session with Dr. Garman is $150.00. Dr. Garman does offer a sliding fee scale to accommodate certain individuals. The offering of a sliding fee is completely at Dr. Garman’s discretion. Payment for services is due at the time of services, unless other arrangements have been made. Payment can be in cash, by check, or with a credit card. If you are using your health insurance for these services, you will be responsible for all co-pays and deductibles outlined by your insurance policy. You will be expected to pay for services not covered by your insurance policy. It is advisable that you check with your health plan or third party payor to clarify the specifics and limits of your policy.
Since the scheduling of an appointment involves the reservation of time specifically for you, a minimum of 24 hours notice is required for re-scheduling or canceling an appointment. Unless we reach a different agreement, a $60 fee will be charged for sessions missed without such notification. Please be aware that insurance does not cover missed appointments, so you solely will be responsible for these fees.
CONTACTING DR. GARMAN
You are welcome to leave confidential voice messages for Dr. Garman at (909) 833-7990. You may also leave email messages for him at any time at email@example.com. Although Dr. Garman is not always immediately available by telephone, a message can be left at this number at any time of day or night. He checks his voicemail frequently and will always attempt to return your call within 24 to 48 hours. With respect to cellular phones, you should be aware that there is the possibility that cellular communications can be intercepted, and for this reason, please carefully consider what information you are willing to communicate via cellular phone. Because the security of email communications cannot be guaranteed, it is recommended that email be limited to requests for phone contact, appointment arrangements, or requests for information. Please only include general information about yourself and your treatment. Any communication that requires immediate attention or a timely response should be made by phone. By signing this document, you consent to Dr. Garman’s use of cellular phones and email to communicate with you.
Although you can leave a message at any time, Dr. Garman is often not available to return your call immediately. In an emergency, please call, and he will return your call as soon as possible. However, if you have an emergency requiring immediate attention please call 911.
THE PROCESS OF THERAPY
Participation in therapy can result in a number of benefits to you, including improving interpersonal relationships and resolution of the specific concerns that led you to seek therapy. Working toward these benefits requires a mutual effort by both the psychologist and the client. Psychotherapy requires your active involvement, honesty, and openness in order to explore your thoughts, feelings, and behavior. There is no one single approach to all situations. The approach is something to be carefully considered as a collaboration between the client and the psychologist. During evaluation or therapy, remembering or talking about unpleasant events, feelings, or thoughts can result in you experiencing considerable discomfort or feelings of anger, sadness, worry, fear, or other unpleasant emotions. The process will sometimes be easy and swift, and may also be slow and even frustrating. There is no guarantee that psychotherapy will yield positive or intended results. If at any time during the therapy you have any questions or concerns, feelings about something Dr. Garman has said or suggested, or need clarification regarding your progress, please feel free to bring this up so it can be discussed.
ENDING OF THERAPY
Psychotherapy is entirely voluntary and you have the right to terminate treatment at any time for any reason. If you have any questions about your rights as a consumer of psychological services, please feel free to ask Dr. Garman at any time. If you believe that you have been treated inappropriately or unethically, you can report the matter to the California Department of Consumer Affairs by calling (916) 263-2699.