IF YOU ARE EXPERIENCING SUICIDAL THOUGHTS OR FEEL AS IF YOU WANT TO HARM YOURSELF OR OTHERS:
CALL 911 OR GO TO THE NEAREST EMERGENCY ROOM
NATIONAL SUICIDE & CRISIS HOTLINE
988
OR TEXT 838255
Our team provides treatment for a variety of addictions including alcohol, opiates, benzodiazepines and food. We are able to prescribe buprenorphine and Vivitrol for medication assisted treatment.
When you choose us, you will not be judged but welcomed with open arms. We strive to provide a safe place for everyone.
Mindplexity Psychiatric Services, PLLC
555 South Perryville Rd. Suite 130
Rockford, IL 61108
Phone: 815-995-2201 Fax: 224-999-4002
This notice went into effect on 12/17/2023
PRACTICE POLICIES
APPOINTMENTS AND CANCELLATIONS
Please remember to cancel or reschedule 24 hours in advance. You will be responsible for the entire fee if cancellation is less than 24 hours without a valid reason such as illness, accident or family emergency.
The standard meeting time for medication management is 20 minutes. It is up to you, however, to determine the length of time of your sessions. Requests to change the 20-minute session needs to be discussed with the nurse practitioner in order for time to be scheduled in advance.
No-show appointments will be subject to a $50 charge. This is necessary because a time commitment is made to you and is held exclusively for you. If you are more than 10 minutes late for an appointment, you will be rescheduled and charged the no-show fee.
A $25.00 service charge will be charged for any checks returned for any reason for special handling.
TELEPHONE ACCESSIBILITY
If you need to contact me between sessions, please email my medical assistant at Mindplexity1@protonmail.com or leave a message on her voice mail at 815-404-3452. I am often not immediately available, however, I will attempt to return your call within 24 hours. Please note that face-to-face or telehealth sessions are highly preferable to phone sessions. However, in the event that you are out of town, sick or need additional support, phone sessions are available. If a true emergency situation arises, please call 911 or any local emergency room.
SOCIAL MEDIA AND TELECOMMUNICATION
Due to the importance of your confidentiality and the importance of minimizing dual relationships, I do not accept friend or contact requests from current or former clients on any social networking site (Facebook, LinkedIn, etc). I believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up when we meet and we can talk more about it.
ELECTRONIC COMMUNICATION
I cannot ensure the confidentiality of any form of communication through electronic media, including text messages. If you prefer to communicate via email or text messaging for issues regarding scheduling or cancellations, I will do so. While I may try to return messages in a timely manner, I cannot guarantee immediate response and request that you do not use these methods of communication to discuss therapeutic content and/or request assistance for emergencies.
Services by electronic means, including but not limited to telephone communication, the Internet, facsimile machines, and e-mail is considered telemedicine by the State of California. Under the California Telemedicine Act of 1996, telemedicine is broadly defined as the use of information technology to deliver medical services and information from one location to another. If you and your provider chose to use information technology for some or all of your treatment, you need to understand that: (1)You retain the option to withhold or withdraw consent at any time without affecting the right to future care or treatment or risking the loss or withdrawal of any program benefits to which you would otherwise be entitled. (2) All existing confidentiality protections are equally applicable. (3) Your access to all medical information transmitted during a telemedicine consultation is guaranteed, and copies of this information are available for a reasonable fee. (4) Dissemination of any of your identifiable images or information from the telemedicine interaction to researchers or other entities shall not occur without your consent.
TELEHEALTH APPOINTMENTS
There are potential risks, consequences, and benefits of telemedicine. Potential benefits include, but are not limited to improved communication capabilities, providing convenient access to up-to-date information, consultations, support, reduced costs, improved quality, change in the conditions of practice, improved access to medication, better continuity of care, and reduction of lost work time and travel costs. Effective medication management is often facilitated when the nurse practitioner gathers within a session or a series of sessions, a multitude of observations, information, and experiences about the client. Nurse practitioners may make clinical assessments, diagnosis, and interventions based not only on direct verbal or auditory communications, written reports, and third person consultations, but also from direct visual and olfactory observations, information, and experiences. When using information technology in therapy services, potential risks include, but are not limited to the nurse practitioner's inability to make visual and olfactory observations of clinically or therapeutically potentially relevant issues such as: your physical condition including deformities, apparent height and weight, body type, attractiveness relative to social and cultural norms or standards, gait and motor coordination, posture, work speed, any noteworthy mannerism or gestures, physical or medical conditions including bruises or injuries, basic grooming and hygiene including appropriateness of dress, eye contact (including any changes in the previously listed issues), sex, chronological and apparent age, ethnicity, facial and body language, and congruence of language and facial or bodily expression. Potential consequences thus include the nurse practitioner not being aware of what he or she would consider important information, that you may not recognize as significant to present verbally to the nurse practitioner.
MINORS
If you are a minor, your parents may be legally entitled to some information about your treatment. I will discuss with you and your parents what information is appropriate for them to receive and which issues are more appropriately kept confidential. Any minor between the ages of 12 and 17 needs to have a valid release of information on file for parent(s) in order for provider or medical assistant to speak with parent without minor present.
TERMINATION
Ending relationships can be difficult. Therefore, it is important to have a termination process in order to achieve some closure. The appropriate length of the termination depends on the length and intensity of the treatment. I may terminate treatment after appropriate discussion with you and a termination process if I determine that the medication management and psychotherapy is not being effectively used or if you are in default on payment. I will not terminate the therapeutic relationship without first discussing and exploring the reasons and purpose of terminating. If medication management is terminated for any reason, I will provide you with a list of qualified psychiatry providers to treat you. You may also choose someone on your own or from another referral source.
Important………Should you chose to see another medical provider for a second opinion and receive a prescription and fill that prescription for the same diagnoses treated by this provider, this professional relationship will be considered terminated unless discussed and agreed upon beforehand.
Copyright © 2024 Mindplexity Psychiatric Services - All Rights Reserved.
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