Appointments and Cancellations

Appointments are scheduled in advance, at a cadence we agree on, based on your goals, treatment needs, and our mutual availability. Payments for each appointment will be made through the respective platform by debit or credit card or ACH transfer.

Insurance companies require diagnosis and treatment planning which can dictate treatment. I provide private pay sessions in which you can attend as frequently as you would like while also limiting released information.

You may cancel appointments in advance without charge, as long as I receive notice at least 20 hours in advance. For appointment no-shows you may incur a fee of $30 dollars (fees are subject to change). Please reach out to me directly for my latest policy on the cancellation cutoff period and fees.

These changes are being implemented due to a time commitment is made to you and this space is held exclusively for you. Due to this, I will be adjusting my scheduling systems so that appointments will need to be scheduled through me. Please reach out via your individual platform, email, or text to schedule or reschedule appointments.

Due to the billing requirements of insurance, if you are 10 or more minutes late, the session will be considered a no-show, and I will reach to reschedule. Certain platforms may state various cut-off times for no-shows, though please note I will be utilizing this 10-minute cut off. At times, I may be able to accommodate if you are going to be more than 10 minutes late, so I just ask you communicate with me ahead of time to see if this is a possibility. Private pay clients are held to this same timeframe.

Appointments for private pay clients will be scheduled for 45 minutes and insurance clients will be scheduled per their particular insurance guidelines (typically 60 minutes).

If your payment is not received by your next scheduled appointment, that appointment will be automatically cancelled.

Availability and After-Hours Emergencies

I will check voicemail and email messages during normal business hours. Messages left outside of normal hours of operation will be picked up the next business day. If you are experiencing suicidal or homicidal thoughts, are in crisis, or need immediate help, please call 911 or go to the nearest emergency department.

Contacting Me

I am often not immediately available by telephone. I do not answer my phone when I am with clients or otherwise unavailable. At these times, you may leave a message on my confidential voicemail and I will return your call once I’ve reviewed your chart, but it may take a day or two for non-urgent matters. I will make every attempt to inform you in advance of planned absences. If I need to cancel an appointment at the last-minute, I will reach out as soon as possible and reschedule.

Discharge Process

There are several reasons why we may eventually end our professional relationship. You may decide you would prefer to work with a different provider. I may reach the conclusion you would be better served working with someone else. Regardless of the case, I will first discuss with you the reasons for discharging, and if you request, provide you with a list of other qualified providers. I will also extend the discharge process length if necessary based on your treatment needs, including continuing to provide emergency support for a time-limited period after you have been notified of the end of our treatment relationship.

Please note that ongoing failure to pay for treatment, attend sessions, or communicate with me in a respectful and timely manner can also result in discharge from my practice. In these instances, to ensure you have continued access to care, I will still make every reasonable effort to get in touch with you and provide referrals to a new provider before I consider our relationship ended.

Should you fail to attend, unless other arrangements have been made in advance, for legal and ethical reasons, we will make several outreach attempts prior to closing your case. If you have 3 “no-show” scheduled appointments in a 6-month period or 3 late cancels in a row, I will close your file with my practice, though you may return to therapy at a more convenient time in the future as discussed with me beforehand.

California Notice to Client:

NOTICE TO CLIENTS: The Board of Behavioral Sciences receives and responds to complaints regarding services provided within the scope of practice of (marriage and family therapists, licensed educational psychologists, clinical social workers, or professional clinical counselors). You may contact the board online at www.bbs.ca.gov, or by calling (916) 574-7830.

Jenna LaVallee

License Number: 128375

Licensed Clinical Social Worker

Expiration: 01/31/2027

What is Telehealth?

Telehealth is healthcare provided by any means other than a face-to-face visit. In telehealth services, medical and mental health information is used for diagnosis, consultation, treatment, therapy, follow-up, and education. Health information is exchanged interactively from one site to another through electronic communications. Telephone consultation, videoconferencing, transmission of still images, e-health technologies, patient portals, and remote patient monitoring are all considered telehealth services

I hereby consent to participate in telehealth with, Jenna LaVallee, as part of my care.

I understand that telehealth is the practice of delivering clinical health care services via technology assisted media or other electronic means between a practitioner and a client who are located in two different locations.

I understand the following with respect to telemental health:

• I have the right to withdraw consent at any time without affecting my right to future care, services, or program benefits to which I would otherwise be entitled.
• There are risks, benefits, and consequences associated with telehealth, including but not limited to, disruption of transmission by technology failures, interruption and/or breaches of confidentiality by unauthorized persons, and/or limited ability to respond to emergencies.
• There will be no recording of any of the online sessions by either party. All information disclosed within sessions and written records pertaining to those sessions are confidential and may not be disclosed to anyone without written authorization, except where the disclosure is permitted and/or required by law.
• The privacy laws that protect the confidentiality of my protected health information (PHI) also apply to telemental health unless an exception to confidentiality applies (i.e. mandatory reporting of child, elder, or vulnerable adult abuse; danger to self or others; I raise mental/emotional health as an issue in a legal proceeding).
• If I am having suicidal or homicidal thoughts, actively experiencing psychotic symptoms or experiencing a mental health crisis that cannot be resolved remotely, it may be determined that telehealth services are not appropriate and a higher level of care is required.
• Electronic communication may be used to communicate highly sensitive medical information, such as treatment for or information related to HIV/AIDS, sexually transmitted diseases, or addiction treatment (alcohol, drug dependence, etc.).
• During a telehealth session, we could encounter technical difficulties resulting in service interruptions. If this occurs, end and restart the session. If we are unable to reconnect within ten minutes, please call or email me to discuss since we may have to re-schedule.
• My therapist may need to contact my emergency contact and/or appropriate authorities in case of an emergency.
• Electronic communication should never be used for emergency communications or urgent requests. Emergency communications should be made to the provider’s office or to the existing emergency 911 services in my community.

By signing below, I understand the inherent risks of errors or deficiencies in the electronic transmission of health information and images during a telehealth visit.

I understand that there is never a warranty or guarantee as to a particular result or outcome related to a condition or diagnosis when medical care is provided.

To the extent permitted by law, I agree to waive and release my healthcare provider and his or her institution or practice from any claims I may have about the telehealth visit.

About psychotherapy services

Psychotherapy is a working cooperative relationship between you and your therapist. Each member of this cooperative relationship has certain responsibilities. Your therapist will contribute their knowledge, expertise, and clinical skills. You, as the client, have the responsibility to bring an attitude of collaboration and a commitment to the therapeutic process. While there are no guarantees regarding the outcome of the treatment, your commitment may increase the likelihood of a satisfactory experience.

As a client in psychotherapy, you have certain rights and responsibilities that are important for you to understand. There are also legal limitations to those rights that you should be aware of. I, as your therapist, have corresponding responsibilities to you. These rights and responsibilities are described in the following sections.

Please note that psychotherapy is not an emergency service. If you are experiencing suicidal or homicidal thoughts, are in crisis, or need immediate help, please call 911 or go to the nearest emergency department.

Benefits and risks of psychotherapy

Psychotherapy has both benefits and risks. Risks may include experiencing uncomfortable feelings, such as sadness, guilt, anxiety, anger, frustration, loneliness and helplessness, because the process of psychotherapy often requires discussing the unpleasant aspects of your life. However, psychotherapy has been shown to have benefits for individuals who undertake it. Therapy often leads to a significant reduction in feelings of distress, increased satisfaction in interpersonal relationships, greater personal awareness and insight, increased skills for managing stress and resolutions to specific problems.

Note that there are no guarantees about what will happen. Psychotherapy requires a very active effort on your part. In order to be most successful, you will have to work on things we discuss outside of sessions.

The first few sessions

The first few sessions typically involve a comprehensive evaluation of your needs. By the end of the evaluation, I will be able to offer you some initial impressions of what our work might include. At that point, we will discuss your treatment goals and create an initial treatment plan. You should evaluate this information and make your own assessment about whether you feel comfortable working with me. If you have questions about my procedures, we should discuss them whenever they arise. If your doubts persist, I will be happy to help you set up a meeting with another mental health professional for a second opinion.

Appointments and cancellations

Appointments are typically held at an agreed upon time each week, at a cadence we agree on (such as weekly or every other week). Payments for each appointment can be made through the respective platform by debit or credit card or ACH transfer.

You may cancel appointments in advance free of charge, as long as I receive notice far enough in advance. For appointment no-shows or last-minute cancellations, you will be charged a fee. Please reach out to me directly for my latest policy on the cancellation cutoff period and fees.

Professional Records

I am required to keep appropriate records of the psychological services that I provide. I keep brief records noting that you were here, your reasons for seeking therapy, the goals and progress we set for treatment, your diagnosis, topics we discussed, your medical, social, and treatment history, records I receive from other providers, copies of records I send to others, and your billing records. Except in unusual circumstances that involve danger to yourself, you have the right to a copy of your file. Because these are professional records, they may be misinterpreted and / or upsetting to untrained readers. For this reason, I recommend that you initially review them with me, or have them forwarded to another mental health professional to discuss the contents. If I refuse your request for access to your records, you have a right to have my decision reviewed by another mental health professional, which I will discuss with you upon your request. You also have the right to request that a copy of your file be made available to any other health care provider at your written request.

Confidentiality

Communication between you and your counselor is confidential. This means that your counselor will not discuss your case orally or in writing without your expressed written permission.

Your counselor has an ethical and legal obligation to break confidentiality under the following circumstances:

1. If there is a reason to believe there is an occurrence of child, elder, or dependent adult abuse or neglect.
2. If there is reason to believe that you have serious intent to harm yourself, someone else, or property by a violent act you may commit.
3. If you disclose that you knowingly develop, duplicate, print, download, stream, or access through any electronic or digital media or exchanges, a film, photograph, video in which a child is engaged in an act of obscene sexual conduct.
4. If you introduce your emotional condition into a legal proceeding.
5. If there is a court order for release of your records.

Additional Rights and Responsibilities

In addition to your right to confidentiality, you have the right to end your counseling at any time, for whatever reason and without any obligation, with the exception of payment of fees for services already provided. You have the right to question any aspect of your treatment with your therapist.

1. You also have the right to expect that your therapist will maintain professional and ethical boundaries by not entering into other personal, financial, or professional relationships with you.
2. If you are unhappy with what is happening in therapy, I hope you will talk with me so that I can respond to your concerns. Such comments will be taken seriously and handled with care and respect. You may also request that I refer you to another therapist.
3. You have the right to considerate, safe and respectful care, without discrimination as to race, ethnicity, color, gender, sexual orientation, age, religion, or national origin.
4. You have the right to ask questions about any aspects of therapy and about my specific training and experience.
5. In circumstances that lead me to conclude that your counseling needs would be better served at another counseling facility, I will suggest an appropriate counselor(s) or counseling agency.
6. Your signature indicates that you have read and understand this information and have received a copy of this consent form and give permission to us to provide counseling services and that this contract is binding for all future sessions you may have with this entity.

I consent to receive text messages or emails from Jenna LaVallee (my “Provider”) and their agents on my cell phone or other devices. I understand that text messages and emails sent by Provider may include appointment reminders or changes in previously scheduled appointments, or may provide advice or education.

Provider does not charge for this service, but I understand that standard text messaging rates may apply as provided in my wireless plan. I have been advised that I may contact my carrier for pricing plans and details.

I understand that I may revoke my request for further communications via text or email at any time by notifying my Provider in writing. However, if I continue to communicate with my Provider via text or email, my Provider can assume that my consent remains valid.

Because e-mails sent over the Internet or texts sent over the control channel without encryption are not secure, I understand the risks associated with e-mail and text messaging, including, without limitation, that e-mails and text messages could be intercepted by unknown third parties; e-mail content can be changed without the knowledge of the sender or receiver; backup copies of e-mail may still exist even after the sender and receiver have deleted the messages; and e-mail can contain harmful viruses and other programs.

My Provider has recommended that I delete all text messages or emails as soon as possible after reviewing them to limit any unauthorized exposure.