Ashley E Allen, LCSW

1. Appointments and Cancellations

1. Please remember to cancel or reschedule appointments at least 24 hours in advance. Failure to do so will result in a $75 fee.
2. The standard duration of a psychotherapy session is 50 minutes. However, you have the flexibility to determine the length of your sessions. Requests to change the duration of the session must be discussed with the therapist in advance to accommodate scheduling.
3. A $10.00 service charge will be applied for any checks returned for special handling.
4. Cancellations and rescheduled sessions not received at least 24 hours in advance will be subject to a $75 fee. This policy is in place to honor the time commitment made exclusively for you. Please note that arriving late for a session may result in a shortened session duration.

2. Telephone Accessibility

1. If you need to contact me between sessions, please send a message through your patient portal or leave a voicemail. While I may not be immediately available, I will make an effort to return your message or call within 48 hours.
2. Telehealth video sessions are highly preferable to phone sessions. However, in situations where you are out of town, sick, or require additional support, phone sessions are available (depending on your insurance policy, as some plans may not cover phone sessions). In case of a true emergency, please call 911 or visit the nearest emergency room.

3. Social Media and Telecommunication

1. In order to protect your confidentiality and maintain professional boundaries, I do not accept friend or contact requests from current or former clients on any social networking site (such as Facebook or LinkedIn). Adding clients as friends or contacts on these platforms can compromise confidentiality and privacy, as well as blur the boundaries of my therapeutic relationship. If you have any questions regarding this policy, please feel free to discuss them during my sessions.

4. Electronic Communication

1. While I am willing to communicate via email for scheduling or cancellation issues, please be aware that email communication is not fully HIPAA compliant. Although my email is HIPAA compliant, the confidentiality of your email cannot be guaranteed. Therefore, I recommend utilizing secure messaging through the Simple Practice portal, which is the preferred method of electronic communication.
2. Please refrain from using electronic communication to discuss therapeutic content or request assistance for emergencies. While I strive to respond to messages promptly, immediate responses cannot be guaranteed.
3. It is important to understand that the use of electronic means, including telephone communication, the Internet, facsimile machines, and email, constitutes telemedicine. By participating in telemedicine services, you acknowledge the following:
4. You retain the option to withhold or withdraw consent at any time without affecting your right to future care or treatment, or risking the loss or withdrawal of any program benefits.
5. All existing confidentiality protections apply equally to telemedicine sessions.
6. You have guaranteed access to all medical information transmitted during telemedicine consultations, and copies of this information are available for a reasonable fee.
7. Dissemination of any identifiable images or information from telemedicine interactions to researchers or other entities will not occur without your consent.
8. There are potential risks, consequences, and benefits associated with telemedicine. These include improved communication capabilities, convenient access to information and support, reduced costs, improved quality, changes in the conditions of practice, better access to therapy, improved continuity of care, and reduced work time and travel costs. It is important to note that therapy often relies on multiple observations, information, and experiences, which may be hindered in telemedicine due to the inability to make certain visual and olfactory observations.

5. Minors

5. Minors

1. If you are a minor, please be aware that your parents may be legally entitled to receive some information about your therapy. I will discuss with you and your parents which information is appropriate for them to receive while maintaining confidentiality on certain issues.

1. Termination

1. Ending therapeutic relationships can be challenging, and it is important to have a termination process to achieve closure. The duration of the termination process will depend on the length and intensity of the treatment. I reserve the right to terminate treatment after discussing it with you and following a termination process if I determine that psychotherapy is not being effectively utilized or if there is non-payment. I will not terminate the therapeutic relationship without first discussing and exploring the reasons and purpose of termination. In the event of therapy termination or if you request another therapist, I will provide you with a list of qualified psychotherapists for further treatment. You may also choose to find another therapist on your own or through another referral source.
2. If you fail to schedule an appointment for three consecutive weeks without prior arrangements, I may consider the professional relationship discontinued for legal and ethical reasons. Additionally, if you miss two consecutive scheduled sessions without communication, treatment will be closed. If needed in the future, a new episode of care can be initiated.

By signing below, I acknowledge that I have read, understood, and agree to the policies contained in this document.