Informed Consent
Introduction
Welcome to Serene Path Wellness. We are a group mental health practice dedicated to providing high-quality mental health care to individuals, couples, and families. Our services include individual therapy, marriage and family therapy, and medication management. This informed consent form outlines the nature of our services, including potential risks and benefits, confidentiality, and your rights and responsibilities as a client. Please read this document carefully and feel free to ask any questions you may have.
Nature of Services
1. Individual Therapy: Individual therapy involves one-on-one sessions with a licensed therapist to address personal mental health issues, emotional challenges, and personal growth goals.
2. Marriage and Family Therapy: Marriage and family therapy focuses on improving communication and resolving conflicts within family systems. This may involve joint sessions with multiple family members.
3. Medication Management: Our medication management services are provided by licensed psychiatric nurse practitioners who assess, prescribe, and monitor psychiatric medications as part of a comprehensive treatment plan.
Potential Benefits and Risks
Benefits:
- Improved mental health and well-being.
- Enhanced relationships and communication skills.
- Better management of symptoms through medication.
Risks:
- Emotional discomfort when discussing personal issues.
- Potential side effects from psychiatric medications.
- No guarantee of specific outcomes or improvements.
Confidentiality
Your privacy is of utmost importance to us. All information shared during therapy sessions is confidential and will not be disclosed without your written consent, except in the following situations:
- If you are at risk of harming yourself or others.
- If there is suspected abuse or neglect of a child, elder, or dependent adult.
- If we are required to release information by a court order.
- If you provide written consent to share information with a third party.
Professional Fees
- The fees for individual therapy, marriage and family therapy, and medication management will be discussed during your initial consultation. Payment is due at the time of service.
- We accept various forms of payment, including insurance. Please verify with your insurance provider that your plan covers our services.
- A fee may be charged for late cancellations (less than 24 hours notice) or missed appointments.
Emergency Contact
In case of a mental health emergency, please contact emergency services or go to the nearest emergency room. Our practice does not provide 24-hour crisis services.
Rights and Responsibilities
Client Rights:
- You have the right to receive respectful and non-discriminatory care.
- You have the right to privacy and confidentiality.
- You have the right to be informed about your treatment and to participate in decisions regarding your care.
- You have the right to refuse any recommended treatment and to be informed of the potential consequences.
Client Responsibilities:
- You are responsible for attending scheduled appointments and providing at least 24-hour notice for cancellations.
- You are responsible for actively participating in your treatment and providing honest and complete information.
- You are responsible for paying for services rendered in a timely manner.
Telehealth Services
We offer telehealth services as an option for clients who cannot attend in-person sessions. Telehealth services are conducted through secure, HIPAA-compliant platforms. By consenting to telehealth services, you acknowledge understanding the potential risks related to technology, including interruptions, unauthorized access, and technical difficulties.
Termination of Services
You have the right to terminate therapy at any time. We encourage you to discuss your decision with your therapist to ensure a proper closure process. Serene Path Wellness also reserves the right to terminate services if:
- You fail to comply with treatment recommendations.
- You engage in behavior that threatens the safety of the therapist or other clients.
- Non-payment for services persists despite attempts to resolve billing issues.
Consent to Treatment
By moving forward with our services, you acknowledge that you have read and understood the information provided above. You consent to receive mental health services from Serene Path Wellness and agree to the terms outlined in this document. You understand that you may withdraw your consent at any time and that you have the opportunity to ask questions and seek clarification regarding your treatment.
Thank you for choosing Serene Path Wellness. We look forward to working with you on your journey to mental well-being.
If you have any questions or need further clarification, please do not hesitate to contact us.