Terms of Service

Last updated: [DATE]

Professional Services Agreement

By scheduling and attending therapy sessions with [THERAPIST_NAME] at [PRACTICE_NAME], you agree to the following terms and conditions.

Therapy Services

Session Information

• Sessions are typically 50 minutes long
• Appointments are scheduled in advance
• Late arrivals may result in shortened sessions
• Regular attendance is important for treatment success

Cancellation Policy

• 24-hour notice required for cancellations
• Late cancellations may be subject to fees
• No-show appointments will be charged full fee
• Emergency situations will be handled individually

Payment Terms

• Payment is due at time of service
• Insurance copays and deductibles are your responsibility
• Payment plans may be available upon request
• Returned checks subject to additional fees

Confidentiality

Therapeutic Confidentiality

• All session content is confidential
• Records are maintained according to professional standards
• Information sharing requires written consent
• Exceptions include safety concerns and legal requirements

Limits of Confidentiality

Confidentiality may be limited in cases of:

• Imminent danger to self or others
• Child or elder abuse
• Court orders or legal proceedings
• Insurance billing requirements

Professional Boundaries

Therapeutic Relationship

• Relationship is professional and therapeutic only
• Dual relationships are not permitted
• Social media connections are not appropriate
• Gifts or personal favors are not accepted

Communication

• Between-session contact should be limited to brief communications
• Crisis situations require immediate professional intervention
• Email and text communications are not confidential
• Response time for non-urgent matters is 24-48 hours

Responsibilities

Client Responsibilities

• Attend scheduled appointments
• Arrive on time and prepared
• Communicate openly and honestly
• Follow treatment recommendations
• Maintain personal safety between sessions

Therapist Responsibilities

• Provide competent professional services
• Maintain appropriate boundaries
• Respect client confidentiality
• Obtain informed consent for treatment
• Make appropriate referrals when needed

Treatment Consent

Informed Consent

• You understand the nature of therapy services
• You consent to the proposed treatment approach
• You understand the risks and benefits
• You may withdraw consent at any time

Emergency Procedures

• Crisis situations require immediate attention
• Emergency contacts will be notified if necessary
• Hospitalization may be recommended for safety
• You are responsible for your safety between sessions

Termination

Ending Therapy

• Either party may terminate therapy
• Appropriate notice and discussion are preferred
• Referrals will be provided when appropriate
• Records will be maintained according to legal requirements

Legal Compliance

This agreement is governed by:

• Professional licensing requirements
• HIPAA privacy regulations
• State and federal laws
• Professional ethics codes

Contact Information

For questions about these terms:

• Phone: [PHONE_NUMBER]
• Email: [EMAIL_ADDRESS]
• Office: [OFFICE_ADDRESS]

By continuing with services, you acknowledge that you have read, understood, and agree to these terms.