1. You have the right to treatment, regardless of race, religion, sex, ethnicity, age, or handicap.

2. You have the right to determine who will provide treatment for you. You also have the right to decide not to receive psychotherapy from me. If you wish, I will provide you with the names of other qualified professionals.

3. You have the right to terminate therapy if so desired. I request that you discuss your desire to terminate treatment face to face so we can process your feelings and provide closure.

4. You have the right to ask questions at any time about the therapeutic process and interventions utilized.

5. You have the right to be treated with dignity and respect.

6. You have the right to know the cost of services rendered.

7. You have the right to receive a written statement of your rights.

8. You have the right to receive individualized treatment, including a verbal discussion of our treatment goals and plan.

9. You have the right to have information discussed within our sessions remain confidential. Generally, no one will learn of our work without your specific written permission. However, there are some exceptions. If you would like your insurance company to reimburse you for your therapy, then you must be willing to allow information regarding your treatment, such as treatment goals, prognosis, diagnosis, and progress to be shared with the insurance company and/or gatekeeper organization. In addition, there are some situations in which I am required by law to disclose information irrespective of your consent. They are the following:

a. If you are at risk of harm to yourself.
b. If you seriously threaten to injure or kill another person, I must inform that individual and the authorities.
c. If you reveal information pertaining to either child or elder abuse.
d. If a court subpoenas me to testify about you.

10. You have the right to be protected from physical, sexual and other abuse.

11. You have the right be informed of your progress.