Appointments

Patients are seen by appointment only. I will do my best to schedule a time that is convenient for you. My sessions are either 45 min or 60 min in length. I have the option of doing extended sessions for 90, 120, or 180 min in length. The initial session is for evaluation. The therapeutic relationship does not begin until we both agree that you will continue with therapy. In the evaluation, if I feel a referral for treatment with another provider or treatment service is warranted, I will make that referral.

Cancellations

Appointment times are held exclusively for you. If you cannot make your appointment, please give me as much notice as possible, preferably at least two days so that another patient can be offered that time. There will be no charge when appointments are cancelled more than 48 hours in advance of the appointment time. If you do not call me at least 48 hours in advance, you will be charged a late cancel fee ($100.00). If you are using insurance, they will not pay for a missed session. Please do not cancel an appointment through electronic communication. Messages of cancellation may be left on my voice mail. I certainly understand if illness forces a cancellation.

Confidentiality

The confidentiality of your therapy is protected by law. Generally, your information will not be released without your written consent. Exceptions to this policy are limited to special circumstances, where I am required by law; threat of serious harm to self or others, suspected child or elder abuse or neglect, or a court order. Also, if you are using insurance, you will be required to authorize the release of any treatment information necessary to process claims or obtain authorizations for treatment. I will, of course, discuss with you any information I am sending to your insurance company.
If you are requesting a copy of your records, I require that you sign an Authorization to Disclose Medical records before I release any information about treatment.
One aspect of therapy is that our relationship will be limited to the professional interactions we have as therapist and client, and therefore I will not respond to any social networking requests. The law protects the confidentiality of our relationship. Exceptions to this are outlined in the Notice of Privacy Practices. If we encounter each other by chance in public, I will respect our confidential relationship and your privacy by either keeping the interaction brief or avoiding acknowledging you, unless you initiate contact first. Please know that despite all security efforts, email and cell phone communication carry an inherent risk of being accessed by unauthorized people that can compromise your privacy. If you convey sensitive personal information this way, I assume you have made an informed decision accepting this risk. Please inform me of any questions or concerns.

Teletherapy and HIPPA Compliance

Zoom medical videoconferencing
Proton email
Hushmail email/forms

All communications, (scheduling, web conferencing, email, transmission of forms with signatures, exercises, or readings) are encrypted and follow HIPPA compliant procedures.

Fees and Insurance

Fees are based on the length of the appointment. My fee is $200.00 for individuals for a 45 min session and $250.00 for individuals for a 60 min session. There are additional charges for letters, reports and extended telephone time. I accept payment by cash, check, or credit card. Payment, in full, is due at the time of service, unless I have a contract with your insurance that requires me to bill them directly. In that case, I will collect the co-payment that is due at each session. Otherwise, I will provide you an insurance claim form for you to submit directly to your insurance company for reimbursement. It is up to you to verify your coverage and if you have a deductible. Please carefully consult your insurance company’s mental health coverage as you, not your insurance company, are responsible for my fee. Insurance companies vary widely in the types of problems they cover, the length of treatment provided and the therapists you can select from in order to receive reimbursement. I can assist you in clarifying your insurance company’s coverage for my services. It is important to understand that any diagnosis assigned to you will become part of your permanent health record. Court Fees: In the unlikely event of litigation, I charge $250.00 per hour. This will include preparation, travel, talking to attorneys, writing time, parking fees; 6 hours shall be paid two weeks in advance of any court appearance. The unused portion will be refunded.

Risk of Life Changes

Therapy, counseling, consultation and education services may have a profound impact. Our work is very intensive and can be stressful. I will give you the option to proceed more slowly or at a more rapid pace. In most cases, there is improvement without unexpected problems. However, it is possible that there may be no change, problems or a disruptive change.

Legal Issues

I will not provide legal advice or forensic services as part of treatment. I may bring up issues for you to consider, but I recommend you seek legal opinions. I do not provide assessments or recommendations in support of legal actions such as child custody, competency evaluations, lawsuits, or criminal charges. Please notify me immediately if you are involved in or may become involved in a legal or criminal matter.

Contacting Your Provider

Due to my work schedule, I may not be immediately available by telephone. When I am not available, my telephone is answered by an answering machine that I monitor frequently. I will make every effort to return your call within 24 hours. If you are difficult to reach, please inform me of some times when you will be available. If you are unable to reach me, and feel that you cannot wait for me to return your call, contact your family physician or if your call is an extreme emergency, call Crisis Intervention at 503-988-4888 or the nearest emergency room and ask for assistance regarding a mental health emergency.

Consent to Treatment

Your signature below indicates that you have read, understand, and agree to treatment and the policies stated above. If, at any time, you have questions or concerns regarding your therapy, please discuss them with me. Remember you have the right to refuse treatment at any time, and to request a referral to another therapist.

Fee Agreement

My fee for individual therapy is $200.00 per 45 minute session or $250.00 for 60 minutes. Individual therapy often lasts either 45 minutes, or 60 minutes weekly depending on your insurance coverage. Family therapy or couples counseling is usually 45 min or 60 min. Longer sessions can be indicated and the cost would be pro-rated (note: insurance may not cover longer sessions).

As a reminder, the scheduling of an appointment involves the reservation of time exclusively for you. If you are not able to keep your appointment, I ask for 48 hour notice. My policy is to charge $100.00 (not your copayment amount) for missed appointments or late cancellations. Insurance does not cover late cancellations or no-shows, and you will be responsible for payment in full. If you need to cancel your appointment you can leave a message any time at (503) 957-2497.

My signature below indicates that I have reviewed this addendum, have had the opportunity to discuss questions/concerns with Robert Poe, Psy.D., and that I agree to honor the terms of the Consent to Treatment (copies available upon request) as agreed per my original signature.