INFORMED CONSENT TO SERVICE
(please read, sign and return)
Please note that application for service will indicate your agreement to the form below.
Read EMERGENCIES, Secure communications, Legal information & Informed consent at bottom menu.
The initial evaluation
The service you are considering usually starts with an evaluation process. The initial evaluation may take 1-3 sessions. In case the initial evaluation also requires diagnostic testing, the specific purpose, duration and cost of such assessment will be discussed ahead of time. At the end of the initial evaluation, alternatives and recommendations are discussed.
One-time expert advice (consultation) sessions, supervision and/or psychological testing services are also available.
Service modality, location and alternatives
Service is available in the Manhattan office, over the telephone and online. If you are not located in NY, please be aware that only educational consults (see below) will be available to you over the telephone or Internet, and that local resources must be used if treatment or in-office health care is needed. Review Emergencies section at OnlineClinics.com's bottom menu for more details.
About psychotherapy (treatment) & consults (expert advice)
What is therapy? In general, the term "therapy" or "treatment" is associated with the process of healing or recovering. Psychotherapy is mostly an interpersonal and personal process which aims to help people understand and better cope with situations, emotions or perceptions. Psychotherapy is also a process of communication and dialogue. The therapeutic dialogue may focus on both intra-personal and inter-personal issues. Throughout the process clients are invited to openly discuss and share feelings, progress and/or concerns with the therapist.
What is a consult? Unlike therapy, consults do not include the full process of diagnosis and recommendations for treatment. Consults are more like getting an expert's advice, but without the agreement to enter treatment or the clinicians' ongoing responsibility for case management.
Fees, appointments, procedures
In case a third party is covering this service, your signature below is to indicate that you agree to forward the reimbursement to the therapist so that the fee for service is covered in full. In office service is $125. Initial online and telephone consults are FREE. Please note that your therapist is open to review fee issues and/or discuss matters related to the service provided AT ALL TIMES during the course of treatment. This includes issues such as scheduling an emergency visit, clarifying treatment strategies, discussing changes in condition, symptoms, etc. See service rates posted in my web office, through: www.RonKraus.com. Please discuss your options if not clear.
Name_____________________Signature__________________ Date______
Telephone________________E-mail______________________ Age ______
Address ______________________________________________________
Emergency contact name_____________ Contact telephone ______________
Please read & fill out the form above. Fax back to: 201 692 8507 |
