New Client Information
New Client Information, Financial Responsibility, &
Please read all sections carefully. It is legally required that I provide you with this information.
Some of it may seem redundant, however, I am working to downsize it as soon as I figure out what is necessary and what is
not. Meanwhile bear with me...
Aims and Goals of Treatment:
The major goal of treatment is to help you identify and cope more
effectively with problems in daily living and to deal with inner conflicts which may disrupt your ability to function effectively.
This purpose is accomplished by:
- Increasing personal awareness and accessing your own abilities
and strengths that you can use to cope and feel good about daily living.
- Identifying your personal goals.
- Increasing personal responsibility and acceptance to make
changes necessary to attain your goals.
- Promoting wholeness through healing and growth.
You are responsible for
providing the necessary information to facilitate effective treatment. You are also expected to play an active role in your
treatment, including working with me to outline your treatment goals and needs and to assess your progress. There can also
be negative consequences if you do not follow through with recommended treatment(s). I will always try to answer any questions
that you may have.
During the course of treatment, I may ask you to do homework
assignments or to practice certain behaviors. It is important to remember that your
progress in therapy often depends much more on what YOU do between sessions than on what happens in the session.
If you know that
you will need me to represent you in court, please be aware that I am not a custudy evaluator or anything related finding
a wrong verses right person or hurting another person, mentally, physically, financially, or otherwise not related to healing
or what I have been trained to do. If your purpose in seeing me is for a legal proceeding, please find another therapist as
these sorts of things go against the goals of therapy, in my opinion.
Initial appointments are usually scheduled for up to 90 minutes. Following sessions are scheduled for approximately 45-60 minutes. My hours are varied and scheduled according to individual needs and my availability.
You may discontinue therapy at any time, but please discuss your
decisions with me as my goal is for you to receive the best, whatever that may be. I do not bite and can handle it if we do
In the event of an emergency, I can be reached at 573-727-6007,
however, if you are suicidal or homicidal, please call 911, or take yourself or have someone else take you to the hospital.
in therapy are important and are generally legally protected as both confidential and “privileged.” However, there
are limits to the privilege of confidentiality. These situations include:
You may be asked to sign
a "Release of Information" so that I may speak with other mental health professionals, family members, or someone else,
if it is in your best interests. You have the right to refuse this, however, legal issues (noted above=) can override your refusal.
SERIOUSLY CONSIDERING SUICIDE, PLEASE LOG OFF YOUR COMPUTER AND
TELEPHONE THE POLICE (911) OR EMERGENCY MEDICAL
- Most courts in the
U.S. have the power to subpoena counseling records if involved in a court case in which they may be somehow relevant. I do
keep records of my services. Although this may be rare, if you have any questions, it is better to contact your lawyer prior
to disclosing any information you may deem private.
- Please be aware
that efforts to fulfill the above obligations are limited by the information that you provide me. I cannot and will not be
held responsible for failure to act if you do not provide me with sufficient information.
- My online services
are not meant to replace regular face to face counseling when your situation requires it. I will make an effort to advise
you of such a need if it appears that your situation is too serious for online consulting.
- Information is limited
in confidentiality due to the nature of internet communication limitations and that I am not liable for any internet related
problems with confidentiality because I am not an internet wizard but merely a therapist trying to make information more readily
available to the public. If you have major concerns with this method of communication, please call (573) 727-6007 instead,
to schedule a face to face session or email DebbieUrbanLPC@aol.com.
I will file your insurance claim, but
you are ultimately responsible for deductibles, co-insurance, co-payments, and if your insurance fails to pay me. It is your
responsibility to familiarize yourself with your insurance benefits.
Initial phone call, online chat, email, or IM inquiries about my services are free.
My standard fees are as following:
Office sessions are $125/hour and by appointment only. If you have insurance
and my services are covered, my fees are then under a provider contract with your insurance company and are paid accordingly
under their rules, by them, however, you are ultimately responsible for my payment and for knowing what your co-pay,
co-insurance payment, deductibles are. Payments are due to me at the time of your appointment.
Pre-scheduled phone calls, online chats, email consultations, or IMs over
15 minutes are billed at $125/hour and must be prepaid.
Brief phone calls, online chats, emails, or IMs under 15 minutes are free
unless they are more than usual.
Extra reports or services for courts or lawyers, if not part of
my standard incuded procedures, will be billed according to how long it takes me to write, travel for notaries, time spent
for court appearances, making files into pdf form for email transmission, or anything over and above my standard services,
at $125/hour. Insurance companies do not cover these services.
Cancellations and Missed Appointments:
It is your responsibility
to notify me, Debbie Urban, at least 24 hours in advance of any cancellations. You may leave messages 24 hours per day. My
voicemail has the time and date for CST.
Except in the event
of a REAL emergency, you will be billed directly for $125.00, for less than a 24 hours notice. Insurance companies generally
do not reimburse for failed appointments. My time is valuable and can
possibly serve another if there is enough time to schedule someone in your place.
Two missed appointments
without a 24 hour notice will result in a cancellation of my services as this usually indicates that you do not really want