Step 1 of 3
1. Mental health assessment, diagnosis, and treatment is generally provided by Kevin McGill, Licensed Independent Clinical Social Worker (LICSW). Treatment is limited to regular talk therapy (psychotherapy) lasting around 50 minutes per session. 2. If psychiatric or medical needs are assessed to be beyond the scope of this practice, a referral will be made for the appropriate care. 3. Thoughts or behaviors indicating an actual or potential risk of suicide or harm to self or others are taken seriously. Evidence of such risk may result in involuntarily hospitalization (commitment) as ordered by a judge. 4. Information about you and your treatment is kept strictly confidential*. This includes the fact that you are (or not) in treatment. Only the client can grant permission for a Release of Information, preferably a signed ROI form specifying the people or parties permitted to access to your protected health information. *A Social Worker is a Mandated Reporter by law. Any evidence of the abuse or neglect of a child, or the abuse, neglect, or financial exploitation of a vulnerable adult must and will be reported to the appropriate authorities. 5. Under Washington State law, conversations a client has with a LICSW are protected as “Privileged Communications”, i.e., a LICSW cannot be compelled to testify about a client in court, just as an attorney or a spouse cannot. The very rare exception to this protection would be by order of the Secretary of State. 6. ALL ELECTRONIC COMMUNICATION IS INHERENTLY INSECURE and susceptible to interception and hacking. A client choosing to communicate electronically (e.g., text messaging, email) assumes all risk and liability of such a breach of privacy. 7. The full rate of service is $200 per session, Private Pay. Sorry, Aristotle is not accepting insurance at this time 8. Cancellations/reschedules must be requested by email a minimum of 24 hours before the scheduled appointment. Refunds are available only for cancelations made outside of this window. Your signature here is an explicit agreement to these conditions of participation in treatment (talk therapy).
I hereby consent to engage in Telehealth. I understand that “Telehealth” includes the practice of health care delivery, diagnosis, and treatment consultation using interactive video, audio, and/or data communications. For Telehealth sessions, I will be connecting using Zoom via Advanced MD Telehealth which is a system that is encrypted to the federal standard and HIPAA compatible. It is my responsibility to choose a secure location to interact with technology-assisted media and to be aware that others could either overhear our communications or have access to the technology that you are interacting with. I agree not to record any telehealth sessions. I understand a live connection could encounter a technological failure and the most reliable backup plan is to contact one another via telephone. I will ensure that I have a phone available. I understand that all fees for telehealth and non-telehealth services are the same. I am financially responsible for all services rendered, late cancellations, and missed appointments Signatures below or signing electronically demonstrate agreement to these conditions and expectations of treatment.