POLICIES

Cancellations - we ask that you inform your therapist 24 hours ahead of your scheduled appointment. Failure to do so will result in being charged the full fee for your session. After two consecutively missed or canceled sessions, we cannot guarantee an open appointment time for you.

Credit Card Use - We request a credit card be kept on file for charges accrued when you are not in the office, such as missed appointment fees, phone calls and documentation requests.

Phone Calls Outside of Scheduled Sessions -In order to respect the time of both you and the therapist we do charge for phone conversations that exceed 15 minutes. The rate for that fee is one dollar per minute.

OUR COMMITMENT TO YOUR PRIVACY

Emerald Coast Therapeutics is dedicated to maintaining the privacy of your personal health information as part of providing professional care. We are required by law to keep your information private. Although these laws can be complicated, we would like to share this important information with you.

How we use and disclose your protected health information with your consent

We will use the information we collect about you to: provide treatment, arrange payment for services, co-ordinate care with Emerald Coast Therapeutics professionals. When you sign the informed consent you are agreeing to let us use your information in these ways. If we want to use, send, share, or release your information for other purposes, we will discuss this with you and ask you to sign an authorization form to allow this.

Disclosing your health information without your consent

There are times when the laws require us to use or share your information.

For example:

1. When there is a serious threat to your or another’s health and safety or to the public. I will only share information with persons who are able to help prevent or reduce the threat.

2. When I am required to do so by lawsuits and other legal or court proceedings.

3. If there is a report of Child Abuse.

4. In case of a medical emergency.

Your rights regarding your health information

1. You can ask us to communicate with you in a particular way or at a certain place that is more private for you. For example, you can ask us to call you at home, and not at work, to schedule or cancel an appointment. We will try our best to do as you ask.

2. You can ask us to limit what we tell people involved in your care or the payment for your care, such as family members and friends.

3. You have the right to look at the health information we have about you, such as your medical and billing records. You can get a copy of these records upon request and for a fee.

4. If you believe that the information in your records is incorrect or missing something important, you can ask us to make additions to your records to correct the situation.

5. You have the right to a copy of this notice. If we change this notice, we will be sure to inform you of this change.

6. You have the right to file a complaint if you believe your privacy rights have been violated. You can file a complaint with Joshua Hostetter, LPC, LMHC, or with the Florida Licensing Board in Tallahassee, FL if in Florida, or the Pennsylvania Licensing Board in Harrisburg, PA if in Pennsylvania. Filing a complaint is a private and confidential process. Emerald Coast Therapeutics works to abide by the laws and ethics of the federal, state, and professional ethics boards of each professionals area of discipline.

7. You are entitled to a Good Faith Estimate of services to be provided to you. To obtain a Good Faith Estimate please request one from your Therapist or Professional Crew Member.