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Terms and Policy

Professional Disclosure
Welcome, I am happy to have the opportunity to work with you. The services I provide include, but are not limited to: individual therapy, marriage and couple counseling, crisis debriefing and relationship coaching. I am glad that you are here and I am committed to providing you with quality care.

Qualifications: I have a Master of Education degree in Counseling and I have completed the requirements to become a Licensed Professional Counselor (license #65655).

Counseling Relationship: During our counseling sessions, we will direct our mutual efforts toward agreed upon goals determined on an individual basis. The sessions will last approximately 45-50 minutes. Although the counseling sessions and educational classes may be very personal, our relationship is a professional one rather than a social one. Our contact will be limited to counseling sessions, and/or classes, and you will be best served if the sessions concentrate exclusively on your concerns.

Effects of Counseling: At any time, you may initiate a discussion of possible positive or negative effects of entering, not entering, continuing, or discontinuing counseling. While benefits are expected from counseling, specific results are not guaranteed. Counseling is a personal exploration and may lead to major changes in your life perspectives and decisions. These changes may affect significant relationships, your job, and/or your understanding of yourself. Some of these changes may be temporarily distressing. The exact nature of these changes cannot be predicted. Together we will work to achieve the best results for you.

I recognize that not all conditions presented by clients are appropriate for treatment with me. For this reason, you and/or I may believe that a referral is needed. In that case, I will provide some alternatives including programs and/or people who may be available to assist you. A verbal exploration of alternatives to counseling will also be made available upon request.

The following actions may lead to immediate termination of the session: arriving for a counseling session or for a class intoxicated or under the influence of an illegal substance, threats or violence to any staff member or to other clients. I reserve the right to discontinue counseling of clients who do not comply with the medication recommendations of their psychiatrist or physician.

In the event of a psychiatric emergency contact the crisis hotline at 1-866-260-8000 or go to your nearest emergency room.

Confidentiality: I will respect the privacy of your records. Information discussed in counseling will not be shared with anyone, unless you have given your written consent. Exceptions and limitations to these parameters of confidentiality are as follows:
- you disclose abuse or neglect of a child, elderly, or disabled person;
- your counselor determines that you a danger to yourself or to someone else;
- if your records are subpoenaed by a court of law; or

In the event that I must telephone you for purposes such as appointment cancellations or to give/receive other information, efforts will be made to preserve your confidentiality. If I see you in public, I will protect your confidentiality by acknowledging you only if you approach me first.

Confidentiality in Couples Counseling
If individual counseling sessions are indicated, I will maintain confidentiality with each partner unless it is believed that information given to me is detrimental to the progress of couple therapy. If I am given information by one partner (including phone calls, or email communication) that appears to be an impediment to progress in couple therapy, I will encourage and support the partner with the undisclosed information to share the information in a conjoint session. I will not share this specific information without the partners consent, but if the partner refuses to share the information in a conjoint session, referral to another therapist is indicated. If information given in an individual session indicates that treatment outside my professional expertise is needed I will provide appropriate referrals.

Fees for Counseling Services
All payments should be made out to Tara Laxson, LPC. Fees are payable at the time services are rendered. I accept cash or checks in the office. If you prefer to pay with a credit card, you must prepay through my website at Failure to pay fees for counseling will result in termination of treatment after appropriate notice and suitable referrals are provided.
Cancellations: When you schedule an appointment time, that time is specifically reserved for you. If unable to keep an appointment, notification by phone 24 hours before scheduled time is required. You will be charged the full fee for any missed appointments without 24 hour notice. After two consecutive missed appointments without notification, your regular time slot will not be reserved.
To ensure proper payment in the event of a no-show and/or late cancellation, the requested credit card information as specified below will be provided by you (the client/legal guardian). You also agree to pay the $25.00 check fee plus bank fees for any checks that are returned for non-sufficient funds.

Fees for court appearance or deposition, if required, shall be no more than $150.00 per hour, payable by the client. In the event that a client's records are ordered released by subpoena, a charge of $75.00 shall be assessed to the client.

Client Rights: The duration of treatment for clients varies. Some clients may need only a few sessions while some clients may need ongoing care over a long period of time. Clients can discontinue therapy sessions at any time. It is recommended that clients participate in a termination session if they have decided to discontinue therapy. This allows for a review of progress, available time for closure, and any appropriate referrals if necessary. The client agrees to communicate to the therapist their decision to end therapy.
My goal is to provide services to you in a professional and ethical manner. If you are dissatisfied with my services, please let me know. If you feel as though I have not behaved in a professional or ethical manner, you may report your complaint to The Texas Board of Examiners of Professional Counselors at: P.O. Box 141369, Austin, TX 78714-1369.

Therapist's Incapacity or Death
I acknowledge that, in the event the undersigned therapist becomes incapacitated or dies, it will become necessary for another therapist to take possession of my file and records.
By signing this professional agreement, I give my consent allowing another licensed mental health professional selected by the undersigned therapist to take possession of my file and records and provide me with copies upon request, or to deliver them to a therapist of my choice.

By your signature below, you are indicating that you have read and understood this statement, or that any questions you had about this statement were answered to your satisfaction, and that you have received a copy of this statement. By my signature, I verify the accuracy of this statement and acknowledge my commitment to conform to its specifications.
( Type Full Name )
( Full Name )
Privacy Notice
Guidelines for Licensed Professional Counselors specify privacy rules for patient records.
New HIPPA regulations protect virtually all patients regardless of where they live or
where they receive their health care. Every time you see a physician, are admitted to the
hospital, fill a prescription, or send a claim to a health plan, your health care provider will
need to consider the privacy rule. All health information including paper records, oral
communications, and electronic formats (such as email) are protected by the privacy rule.

The privacy rule also provides you certain rights, such as the right to have access to your
medical records. However, there are exceptions; these rights are not absolute. I also take
precautions to safeguard your health information such as employing computer security
measures. Please feel free to ask questions about exercising your rights or how your
health information is protected in my office.

The Notice of Privacy Practices is available for review in my office, and also on my website, It describes how you can exercise your rights with regard to
protected health information, and how your confidential health information is protected.
I have had access to the Notice of Privacy Practices and am aware of my rights.
( Type Full Name )
( Full Name )