Eutierria Therapy

Your Rights as a Client

As a client, you have the following rights:

• Respect and Dignity: You have the right to be treated with respect at all times, free from harsh or unfair treatment and without discrimination based on race, religion, gender, or any other unlawful category.

• Qualified Care: You can expect that your therapist has met the necessary training and experience qualifications required by state law. You also have the right to verify your therapist's credentials through public records maintained by the licensing board.

• Privacy and Confidentiality: Your privacy is important. Your information will be kept confidential, except in specific situations where the law requires disclosure, such as:

  • Suspected child abuse.

  • Imminent danger to yourself or others.

  • Legal requirements in court or with your insurance company.

  • Case consultation or supervision.

  • Defending against claims you may bring against your therapist.

  • Emergencies where your name may need to be shared with emergency personnel.

• Control Over Information Sharing:

  • Request Limits on Sharing: You can ask us not to share certain information, although we may not always be able to agree if it affects your care.

  • Out-of-Pocket Payments: If you pay for a service out of pocket in full, you can ask us not to share that information with your insurance.

  • How We Contact You: You can tell us how and where you prefer to be contacted about your health information (e.g., by phone or mail).

• Access to Your Information:

  • See and Get Copies of Your Information: You have the right to see or get a copy of your health records. I’ll provide it within 30 days, and there may be a small fee.

  • Get a List of Disclosures: You can ask for a list of when and why your health information was shared (other than for treatment, payment, or healthcare operations).

  • Correct or Update Your Information: If you think there’s a mistake in your health information, you can ask us to correct it. I’ll respond within 60 days.

  • Get a Copy of This Notice: You can request a paper or electronic copy of this notice at any time.

• Code of Ethics: You can request a copy of the Code of Ethics that guides your therapist's practice.

• Filing Complaints: If you have concerns, you have the right to report them to the relevant state licensing board.

• Cost Information: You have the right to be informed about the cost of services before you receive them.

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Your Responsibilities as a Client

As a client, you are responsible for:

• Providing Accurate Information: Please provide accurate and complete information about your current issues, medical history, and other relevant life circumstances.

• Understanding Your Treatment: It’s important to let your therapist know if you have any questions or if something about your treatment is unclear.

• Reviewing Documents: Make sure to read all relevant documents, including the Informed Consent for Treatment, Privacy Practices, and any other forms provided to you.

• Keeping Appointments: Please keep your scheduled appointments. If you need to cancel, notify your therapist at least 24 hours in advance.

• Following Treatment Recommendations: While therapy is voluntary, your therapist may provide specific recommendations based on your needs. Not following these recommendations could have consequences, which will be discussed during your sessions.

• Paying for Services: You are responsible for paying all fees for treatment at the time of service.

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Acknowledgment of Privacy Notice

• By becoming a client, you acknowledge that you have received a copy of the Privacy Notice, as required by HIPAA. Your therapist will also explain your rights under HIPAA and answer any questions you may have.