Welcome
Welcome to my practice. I look forward to finding out more about
you and getting started on our work together. This introductory
document is long and more focused on legalities than I would
prefer, but it is necessary to fulfill the requirements of the
State of Colorado Department of Regulatory Agencies. Hopefully it
also conveys useful information about your rights and
responsibilities as a client and about my approach to treatment.
Don't hesitate to ask questions or discuss anything you would
like to know more about.
Names
The legal name of my practice is Dr. Heather Smith LLC, also
known as Artful Science (my DBA). In this document and my
other forms I will refer to you as either a client or a patient.
I will use those terms interchangeably.
Educational and Licensing Information
I hold Masters of
Science and Ph.D. degrees in Counseling Psychology from Colorado
State University
I am licensed in
Colorado as a Psychologist (License #3984, expires 8/2025)
As to the regulatory requirements applicable to mental health
professionals: A Licensed Psychologist must hold a doctorate
degree in psychology and have one year of post-doctoral
supervision. (I meet these qualifications and have over 20
years of psychotherapy experience.)
Regulation of Psychotherapy
The practice of licensed or registered persons in the field of
psychotherapy is regulated by the Mental Health Licensing Section
of the Division of Registrations. They require that I
include the following information:
In a professional
relationship, sexual intimacy is never appropriate and should be
reported to the Department of Regulatory Agencies, Mental Health
Section.
You are entitled to
receive information about my methods of therapy, the techniques I
use, and the duration of therapy (if I can determine it).
You are entitled to
know my fees for services.
You may seek a second
opinion from another therapist or may terminate therapy at any
time.
My records will be
maintained for seven years from the date of treatment.
Any questions, concerns, or complaints regarding the practice of
psychotherapy may be directed to: Department of Regulatory
Agencies, Professional Counselors Examiners Board, 1560 Broadway,
Suite 1370, Denver, CO 80202; Phone: (303) 894-7800.
It is my hope that you would address any concerns that you might
have about your counseling experience directly with me. My
goal is to provide you with high quality, ethical service and
your feedback will help me to make sure that I am doing that. If
you perceive there to be a problem I would like the opportunity
to make the necessary changes to resolve it.
Confidentiality
One of your most important rights as a client involves
confidentiality. Generally speaking, the information provided by
and to the client during therapy sessions is legally confidential
and cannot be released without the client's consent. There are
exceptions to this confidentiality, some of which are listed in
section 12-245-301 - 12-245-309 of the Colorado Revised Statutes
(http://www.lexisnexis.com/hottopics/Colorado/ ) and the HIPAA
Notice of Privacy Rights you were provided, as well as other
exceptions in Colorado and Federal law. For example, mental
health professionals are required to report child abuse to
authorities. If a legal exception arises during therapy, if
feasible, you will be informed accordingly.
Confidentiality Guidelines for Work Involving More Than One
Person
Confidentiality in Discernment Counseling and other forms of
multiple-client counseling requires additional considerations to
those of individual therapeutic work. When working with a couple
or group I regard the relationship as the client. Depending on
the situation I may meet with clients either together or
individually. I may also refer one or both clients for
individual work with another therapist if it appears concerns may
best be addressed separately. In general I treat
information shared in individual sessions confidentially, though
I may encourage information to be shared by you in the couples'
sessions. Note that in any couples or group counseling there is
the risk that I may inadvertently share confidential information
because of the common cognitive error of source confusion
(misremembering who shared the information with me). This
is also true if you refer someone you know to me and I am meeting
with each of you individually.
If you are in individual counseling with me and decide to bring
in another person who is not also my client, my intention cannot
be to treat that person. Most often they are invited in to share
information that will help me in my work with you, because you
need to include them in implementing your treatment plan. While I
would never intentionally share anything with that person that
you have told me in confidence, I cannot guarantee that no part
of the conversation will reveal anything about you that you would
not want them to know. Please know that this is a risk that you
take if you choose to bring another person into your individual
therapy session.
Consultation with Other Professionals
In conformance with ethical guidelines and to assure highest
quality care, I may occasionally discuss your treatment with
other licensed mental health professionals, but your anonymity
will be maintained whenever possible. The professionals consulted
are also legally bound to keep the content of our consultations
confidential.
Appointments and Late Cancellations
Please call (720) 263-1185 to schedule your appointments. If you
are unable to keep an appointment, please notify me 24 hours in
advance to cancel or reschedule. Since I recognize that
unexpected circumstances sometimes arise I will forgive one no
show/late cancellation, but after that I will charge a $50 fee to
help me cover the expense of having your slot not filled.
If I have your credit card on file I have the right to charge
your card for this fee without your explicit permission, though
in practice I will generally discuss the situation with you
first. As with all parts of this document, please talk to me if
you have any concerns about how this policy applies in your
situation.
Contacting Me, Privacy and Online Services
Due to the nature of my work, I am often not immediately
available by phone. If you need to talk with me between
appointments, call my business phone at (720) 263-1185. If I
can't speak with you at that time, leave your message on my
voicemail with day and evening phone numbers and I will return
your call as soon as possible. There may be times when I am
unable to receive or respond to messages quickly, such as when
I'm out of cellular range or out of town. If you have left a
message and haven't received a call back please don't hesitate to
text me.
When you do text me, please be patient with the fact that I often
do not see text messages right away or reply immediately. Also,
note that I don't receive texts directed to the phone number
listed in some online directories - please text my 720-263-1185
number. It helps if you include the best times to reach
you. If I have not returned your call or texted back within
24 hours please leave another message for me because technology
sometimes fails. For example, when I am traveling there is no way
for me to set an away message for my text messages. If you choose
to text me I would prefer that you use Signal Messaging, a free
and highly secure app that will provide added security and
confidentiality to our communication. It can be downloaded for
free from www.signal.org .
If you have a message of substance I would prefer you send a
secure message through my client portal
(https://DrHeatherSmith.secure-client-area.com) or phone me.
You are welcome to email me at Heather@drheathersmith.com, but it
is better to message me through my secure site
(https://DrHeatherSmith.secure-client-area.com). Please be aware
that email is not a secure form of communication and I cannot
guarantee your confidentiality; my client portal is more secure
and confidential, though of course no electronic system is
completely risk-free. If you choose to use email or text or leave
a voice message to communicate with me, you are indicating that
you recognize the dangers and potential for breach of
confidentiality associated with these technologies and are
willing to accept this risk. Please also realize that while I
check email most days I cannot guarantee that I will always
receive it and reply immediately, so please do not use email to
communicate time-sensitive information - please call me. Lastly,
while I am always open to receiving messages and will read what
you write, I may not send a detailed response. Please do not
interpret that as a lack of interest; it is just not feasible for
me to provide therapeutic services in writing. We can discuss
what you've written in our next therapy session.
Please know that if we use electronic communications methods,
such as email, texting, and online video, there are various
technicians and administrators who maintain these services and
may have access to the content of those communications. Of
special consideration are work email addresses. If you use your
work email to communicate with me, your employer may access our
email communications. There may be similar issues involved in
school email or other email accounts associated with
organizations that you are affiliated with. Additionally, people
with access to your computer, mobile phone, and/or other devices
may also have access to your email and/or text messages. Please
take a moment to contemplate the risks involved if any of these
persons were to access the messages we exchange with each other.
For all record keeping, including my appointment calendar, I use
a secure, HIPAA compliant system that is operated by Counsol. I
also use Google Calendar but only your client number shows up in
that system. I may store your first name (and sometimes last
initial, or just your initials) and phone number in Google
Contacts so that I have your number readily available in case I
need to contact you and so I know who you are if you call in or
send me a text message. If you do not want me to store your
number in Google Contacts please let me know and I will keep it
only in my secure client system.
For video sessions, I use a range of HIPAA compliant platforms
including Counsol, VSEE, Google Meet, Doxy.me, and Spruce. I have
not been able to find one software solution that works on every
technology, so I offer a range of options. We may have to
experiment to find the right one for us.
Please refrain from making contact with me using social media
messaging systems such as Facebook Messenger or LinkedIn. The
current ethical standards of my profession take a negative view
of using social networking to communicate with clients and do not
allow me to "friend" you. Also, I personally don't check those
websites often, and they have terrible security. Please just use
my messaging system, text, email or phone if you'd like to send
me a message.
Mental Health Emergencies
In case of a mental health emergency call me at 720-263-1185. If
you are unable to reach me please call your physician or
psychiatrist, or call the national mental health crisis hotline
988. You could also visit the Colorado Crisis center at
http://coloradocrisisservices.org. They have a free,
confidential phone number -844-493-TALK(8255) - that you can call
24/7, as well as a list of locations you can visit to get
immediate help. You can also call 988, the national mental health
crisis hotline. If you feel in imminent danger of harm you
should not call me but rather should go directly to the crisis
center or to a local hospital (one nearby hospital specializing
in mental health issues is Centennial Peaks.) You can also visit
your nearest emergency room or call 911.
Please note that SMS (normal phone text messages) are not
designed for emergency contact. Text messages occasionally get
delayed or even lost. So, please refrain from using texting as
your sole method of communicating with me in emergencies.
Termination
Therapy is a two-way, genuine relationship between therapist and
client. I care about my clients and think about them between
sessions and after they stop seeing me. When clients drop out
unexpectedly it is difficult for me and I wonder what happened. I
recognize that people discontinue treatment for many good
reasons. Sometimes they are feeling better and no longer need my
services. Sometimes they can no longer afford to continue
with me. Sometimes they are dissatisfied with the services I've
provided. When you are ready to discontinue therapy, I would
appreciate it if you would tell me that directly and let me know
why you've decided to stop coming in. If possible, I would like
to have a termination session with you to discuss our work and to
say goodbye. If I have done something that has hurt you or that
you didn't like, I'd appreciate the chance to apologize and
repair our relationship if possible. If you do stop coming in and
I haven't heard from you, I may call, text or email to check in
and see how you are doing. If I still haven't heard from you
within two months I will consider your file closed, but you are
always welcome to come back at a later date and I will happily
reopen your file.
It is also important for you to know that I am ethically required
to terminate services with you if it is clear that you are not
benefitting from treatment, or if I believe that the services you
require are beyond my scope of expertise. I will, of course,
first talk with you about this decision and what your options are
for receiving treatment elsewhere. In addition to my legal and
ethical obligations to refer out, I strongly believe that it is
the clinically correct thing to do when I am not being as helpful
as you need me to be. Psychotherapy outcome research indicates
that transferring to a different therapist when you are not
making progress is likely to result in you getting back on track
and moving toward your treatment goals. No matter how much we
might feel connected to each other and enjoy our sessions, if you
are not getting the results you want and I have tried
unsuccessfully to address that problem you should switch to a
different therapist. That often feels difficult for both of us
when it happens, but it is worth the discomfort for you to get
the help you need to have the life you want.
Fees
My regular fee is $185 for a 53-minute session and is due at time
of service unless we specifically make other arrangements (such
as a reduced rate based on my sliding scale - see below). Session
length and frequency can be modified based on your needs and fees
will be adjusted accordingly. My initial intake session is 84
minutes and $275. Discernment Counseling Couples meet for 115
minutes for the first session for $360, and follow up sessions
are 84 minutes for $275. Most clients prefer that I charge the
credit card on file in my secure records system at the end of
each session, but I also accept cash, checks, Paypal, Venmo and
Zelle. You can view your invoices and payment history through my
secure client portal
(https://DrHeatherSmith.secure-client-area.com).
Your payment might be a tax-deductible medical expense (but
please consult a tax professional for details about claiming that
deduction). You may also be able to pay my fees from a tax-exempt
Health Savings Account or Flexible Spending Account.
Insurance
I am contracted directly with Colorado Access, CCHA, and Carelon
Behavioral Health (all Medicaid), Medicare, Lyra and the
Veteran's Affairs Community Care Program. For other insurance
payers I will be glad to provide out-of-network service and
provide you with a superbill for services rendered should you
desire to seek insurance reimbursement on your own. For many
out-of-network insurers I will be glad to submit the claim in
your behalf, though I will require payment up front and they will
reimburse you directly. If you want to bill your insurance,
please share that information with me at the beginning of
treatment.
Please let me know in advance if you have Medicaid coverage. It
is illegal for me to charge money for any service Medicaid would
have covered. I will simply bill Medicaid for your sessions with
me.
Similarly, if you have Medicaid and another primary insurance, I
am legally required to bill your other insurance first. Medicaid
is always secondary. Please let me know if you have insurance in
addition to your Medicaid.
Note that you are responsible for the cost of services should
your insurance company deny your claim or fail to pay. I will do
everything in my power to avoid this situation, and we will
discuss up front what you can expect your costs to be. In some
cases (such as with some types of Medicaid) you may be legally
exempt from paying me directly. In most cases, however, I am
billing insurance as a convenience to you and you are agreeing by
signing this document that you will pay any charges incurred.
You should be aware if you are using insurance your contract with
your health insurance company requires that I submit information
relevant to the services provided to you, including a clinical
diagnosis. Sometimes I am also required to provide additional
clinical information such as treatment plans or summaries, or a
copy of your entire clinical record. Though insurance providers
are mandated to keep that information confidential, I obviously
have no control over how the information is used. By signing this
form you agree that I can provide requested information to your
insurance carrier if they are being billed for sessions. Of
course if we do not bill your insurance company for services this
does not apply and no information will be released to them.
Credit Card Transactions
I use Bluepay for credit card transactions. They are processed
through Counsol, the electronic database I use to maintain all of
your clinical records and for secure messaging. Bluepay will
store your masked credit card number so that I can run charges
after our sessions without having to get your credit card
information each time, and in signing this document you are
giving me permission to do that. Bluepay or Counsol may send you
receipts for payment by email or text message. These receipts
will include my business name, and may indicate that you have
paid for a therapy session. The receipt will go to the phone
number or email you have on file with me. Please make sure that
you are comfortable receiving confirmation emails at those points
of contact, and think through who else might have access and
whether that could create an unwanted confidentiality breach
(e.g. using a work email address could allow others in your
company to see you are making and paying for appointments with
me).
In addition to these possible emails or text messages, payments
made by credit card will appear on your credit card statement as
being made to Dr Heather Smith, LLC. Please consider who might
have access to your statements before making payments by credit
card.
Health Savings Accounts and Flexible Spending Accounts
If you are using a Health Savings Account (HSA) or Flexible
Spending Account (FSA) payment card, please be aware that even if
your payment goes through and is authorized at the time that we
run your card, there is a possibility that your payment could
later be denied. In the event of this happening, you are
responsible for ensuring that full payment is made by other
means. If your financial institution is requesting receipts, you
can easily obtain documentation through the client portal
(https://DrHeatherSmith.secure-client-area.com).
Financial Need
For those who demonstrate financial need using proof of income, I
can temporarily provide services on a sliding scale based on
income and family size. The scale is available on request. Please
note that you must request a sliding scale rate in advance
of receiving services; I will not routinely ask if you are
eligible for a reduced rate. I might refuse your request to work
with me on a sliding scale if my allocated sliding scale slots
are already full, and offering the scale does not obligate me to
take clients at these rates. If you do work with me at a reduced
rate we will reevaluate and reset your rate at least once every
six months. I may also revise your rate at any time in response
to a change in your financial situation.
Additional Services
If you ask me to provide other services such as report writing,
telephone conversations lasting longer than 10 minutes, or
preparation of records or treatment summaries, I will charge my
regular hourly fee. Matters such as court testimony, evaluations,
and child custody are not within the scope of my work. I do not
testify in court in behalf of clients because I believe it
impedes our therapeutic relationship and creates a potential
conflict of interest. I do not participate in any way in child
custody or divorce proceedings. I will not respond to a subpoena
from an attorney. If you become involved in legal proceedings in
which a judge orders my participation you will be expected to pay
for all of my professional time, including preparation and
transportation costs, even if I am called to testify by another
party. I charge $500 per hour for preparation and attendance at
any legal proceeding.
Consent
I have read the preceding information (parts of which will also
be presented verbally) and I understand my rights as a client or
as the client's responsible party. I consent to receiving
counseling and/or other psychotherapeutic services provided by
Dr. Heather Smith LLC and agree to abide by the requirements
outlined above.
Feel free to ask questions after reviewing this form. I
look forward to working with you!
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