Online concierge therapy for adults in Florida afternoons and evenings.
Appointments and Cancellations
Policies and Procedures
These policies were last updated March 16, 2024
Appointments
Preferred Times
On your initial contact form, I will ask you to indicate your preferred appointment days and times. I will also ask what format you prefer (video, phone, text), how often you’d like to meet starting out, and your preferred session length (e.g. 30 minutes, 60 minutes).
Available Session Times
I schedule appointments seven days a week from 12pm-9pm ET.
This does not mean I am available nine hours a day, seven days a week. It means these are the hours during which I schedule appointments. Some days and time slots are for video sessions and other time slots are limited to phone or text sessions.
Because I run a concierge service, I do not book appointments back-to-back. My schedule tends to book up a week or more in advance, so please keep that in mind if you've got a time preference.
Session Formats
I offer online therapy sessions via HIPAA-compliant video, phone, and text-messaging. Video and phone sessions are synchronous. Text messaging is asynchronous. You may occasionally get an immediate response to a text or email, but that will be unusual and should not be expected.
Video
I schedule video therapy sessions Tuesdays, Thursdays, and Saturdays between 12pm and 9pm ET, pending availability, with the last video session starting no later than 8pm ET.
Phone
I schedule phone therapy sessions seven days a week from 12pm-9pm ET, pending availability, with the last phone session starting no later than 8pm ET.
I do not answer phone calls except by appointment - no exceptions.
If you are in distress and require emergency services, please call 911 or find immediate help from these resources.
Text Messaging (asynchronous)
I offer therapy via text messaging throughout the week from 12pm-9pm, seven days/week. Please see my FAQs for the fee structure of text-based therapy.
Session Frequency
I recommend a weekly one-hour session at minimum for the first 6 months. Weekly appointments lead to greater momentum and focus, so therapy tends to be more productive overall. I suggest a weekly video session for at least one month before switching to phone or text-messaging as primary channels for therapy.
Every six months, we will review session frequency and format and discuss changes to the schedule based on what’s clinically indicated. If you feel a change is warranted sooner, feel free to bring it up in session so we can discuss it.
A minimum of one monthly video or phone session is required to stay on my caseload unless we explicitly arrange otherwise. I cannot be responsible for your care if I am not actively treating you.
Standing Appointments
If you prefer a certain day and time, I recommend that you book a standing appointment so you will have that slot reserved. A standing appointment is a recurring appointment. This means that you are reserving the same day/time slot every week or every other week (fortnightly).
If you book a standing appointment every other week, the alternate week will be booked with another client who does the same. This means that if you need to reschedule, I may not have that slot open on the alternate week, so you may have to take a different slot or wait a month until your next regularly scheduled appointment. Please understand that If you book a standing appointment for every other week and the alternate week is not also filled with a standing appointment within a month, I may need to move your appointment day and time.
Provision of standing slots is at my discretion. Standing appointments follow the same cancellation policies and procedures as any other appointments. Please do not schedule standing appointments unless you are certain you can commit to this time slot.
Repeated cancellations for standing appointments is an indication that this is not a feasible time slot for you. If you reserve a standing appointment and cancel or reschedule it two times in a row, I will ask you to move your standing appointment to another slot or schedule your appointments from week to week instead.
Please note that I will not hold a standing slot if you take a leave of absence from therapy.
Initial Session
Your initial session will take 60-120 minutes, so please keep that in mind when you schedule. You will need to complete the intake process and sign an informed consent agreement before your first appointment.
Once I have received your signed informed consent and completed intake documents, I will send you a text or email and we will set up your initial session. I will give you appointment times to choose from based on the preferences you indicated on your initial contact form. Once you’ve chosen a time slot, I will send you an acknowledgement and a payment link.
Your appointment is not confirmed until payment has been received. Payment must be received no later than 24 hours prior to your appointment or the appointment will be automatically canceled. I will send you a session link once I receive notification confirming your payment. Please see the cancellation policies and procedures below for more details.
Appointment Process
Appointment Reminders
You will receive appointment reminders via text and email at approximately 48 hours and at 24 hours. These reminders are a courtesy. Failure to see a reminder will not result in a waiver of fees for later cancellations or missed appointments. You are responsible for keeping appointments as scheduled whether you have viewed these reminders or not. I recommend that you add your appointments to your phone calendar and set up reminder alerts.
Session Check-In
The day of each session, from your initial session on forward, you will receive a web-based check-in form that can be completed on a computer or any mobile device. This form is not publicly available. You will receive a link to the check-in form when you set up your appointment, and then again with your appointment reminders. You can also find the link in your private e-library. The check-in form will include a brief spot-check self-assessment. The self-assessment gives us an ongoing opportunity to monitor your state of mind and helps you track your progress in therapy.
Arrive Early
It is a good idea to be online at least five minutes prior to your appointment time. This gives you a chance to complete the check-in form, troubleshoot any login issues, and restart your computer if something isn’t working right. Think of it as the equivalent of coming to an appointment in person and getting there early to check in so your appointment starts on time.
Cancellations
Please help me to serve you and others better by keeping your appointments as scheduled. If you need to cancel or reschedule, please give as much notice as possible so I can offer that time to someone else. I will do my best to reschedule your appointment within the same week based on availability. At times, it may be necessary to set up your rescheduled appointment via phone rather than video conferencing based on scheduling availability or equipment and/or internet issues on either your end or mine.
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If you need to cancel, I suggest canceling via both text and email just to make sure your message reaches me. You will have two email addresses and two text messaging apps through which to contact me. Feel free to send your message at any hour of the day or night. I keep device and application notifications set to silent, so you will not disturb or wake me.
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You pay for the time you schedule. If you are late to your session, you will be seen for the remaining time and charged the full fee. If you choose to end a session early, you will not be refunded for the remainder of the scheduled time.
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By scheduling an appointment, you commit to paying for that time, whether you show up on time, late, or not at all. If you are late to your appointment, but you show up, you will be charged for the scheduled time. If you're late, you're late. I won't take offense. But please be aware that if you're late, your appointment will not be extended past the originally scheduled time slot.
If it's a video session, I will remain on the video call for up to 15 minutes. After that, I will log off video but will be available via text in case you are able to show up late. At that time, we can decide whether to complete the session via video or phone. At 30 minutes past the scheduled appointment time, you will be considered a no show.
I will send text and email nudges if you are late, but those are a courtesy. Failure to see a text or email nudge will not result in a waiver of fees for late cancellations or missed appointments. You are responsible for showing up to your scheduled appointments whether you have viewed these nudges or not.
Please make a point to check your calendar for conflicts prior to scheduling. Most telemental health clients find it helpful to set appointment reminders on their phone calendars.
I make it a priority to be punctual to your appointments. I do everything I can to prevent unforeseen events, including technical issues, but they may happen. If you are ever inconvenienced by tardiness on my part, for any reason, I will credit you in time equivalent to the time missed and not as a refund in currency. You can choose to add that time to that day’s session if it’s available, or add it to a future session.
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I have redundancies built into my technology infrastructure. For example, if video isn’t working, we can switch to audio only. However, there may be events that are out of my control, such as an internet or power outage.
In the event that internet and mobile connections are both down on my end, I will make every effort to reschedule your appointment for the same week - later that same day, if possible.
Because an opportunity is provided to use an alternate application or to reschedule, I do not issue refunds when an appointment cannot be completed due to technical issues.
If the problem occurs on your end, we will also make every effort to reschedule that day or that week. If it happens repeatedly, we will need to examine your technology and confirm that it's possible for you to access this service reliably.
Reliable internet is a necessity for services with this practice. If your internet is unreliable, I recommend you seek local, in-person services.
Rescheduled appointments for frequent last minute cancellations due to technical issues may result in termination of services.
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If you are unable to attend a session, please provide as much notice as possible. When you cancel a scheduled session without at least 24 hours notice, it compromises my ability to offer that slot to someone else who needs it.
If you cancel with more than 24 hours notice, we will reschedule your session for the soonest available time. If you cancel half your appointments or more within a month, you will need to schedule appointments on the same day going forward, pending availability.
If you are going to be out of state during a scheduled appointment, please cancel in advance to avoid a late cancellation fee. See my travel policy for a discussion of the alternate arrangements that might be possible, but please be aware that these arrangements will need to be made well in advance if they are even possible.
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A cancellation is considered late if you cancel less than 24 hours prior to the scheduled appointment time. After three consecutive cancellations by the same client, the policy changes to 48 hours notice, and a cancellation will be considered late if you cancel less than 48 hours prior to the scheduled appointment time.
Make sure to cancel your appointment at least 24 hours before your scheduled appointment to avoid a late cancellation fee. A cancellation fee is not a punishment. You’ve booked the spot and if you cancel with little or no notice, it cannot be offered to another client in time.
I reserve the right to terminate therapy with clients who show a pattern of late cancellations. If you’re on my caseload, I have a responsibility to meet with you regularly. If meeting at the scheduled time isn’t working out for you, please talk to me about finding a different time or switching from video to phone sessions.
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The first late cancellation will be charged at 50% of your scheduled session fee as a one-time courtesy for active clients. This courtesy will be handled as a credit, not a refund. The credit will be applied toward any appointment in the two weeks that follow the cancellation. It will not be refunded.
Any late cancellations thereafter will be charged at 100% of your scheduled session fee.
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Note that this section refers to repeated cancellations within the cancellation window.
After three consecutive cancellations by the same client, the cancellation policy window changes from 24 hours notice to 48 hours notice. If you do not cancel within the cancellation window, you will be charged for the appointment per the late cancellation fees.
When you cancel or reschedule 25% of your appointments, it is appropriate to evaluate whether this is a good time to initiate discharge or to switch from scheduled appointments to provisional appointments. Provisional appointments may be a more workable option for clients with unpredictable schedules or lifestyles.
Provisional appointments are same-day appointments that are made less than 24 hours in advance. They are called provisional appointments because they are offered on the provision that the time is available.
Here's what the process looks like for provisional appointment sessions:
When you'd like a session, you call, text, or email.
If I have space available that day, we will set up an appointment.
Because it is a same-day appointment, you will be charged immediately to reserve the spot.
Note that there will be no refunds for canceling same-day appointments, so please do not schedule a same-day appointment unless you are able to commit to it.
If the cancellation rate increases to 30% of appointments, you will be discharged and referred to community resources.
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A “no show” is when you simply do not show up for a scheduled appointment, including an online appointment - without calling, texting, or emailing. It is a missed session.
If you do not cancel with at least 24 hours notice and do not show up for an appointment, that’s considered a missed appointment or a “no-show.” The full fee will be charged for missed appointments based on the amount of time scheduled. If you show up 30 minutes late, that will also be considered a missed appointment, aka no show.
When you schedule an appointment and do not show up and do not bother to cancel, you make it impossible for me to book that time for someone else. There will be no refunds for no shows, and you risk termination of services if it happens repeatedly.
With text, email, and voicemail, there is always a way to let me know if you cannot make your appointment, except in the case of an emergency. In limited circumstances, I will consider issuing a credit in the case of an emergency. Documentation of the emergency may be requested. There will be no refunds for no shows/missed appointments, only credits, and only for emergencies.
Emergencies:
You are in the emergency room.
You are in the emergency room with an immediate family member.
Someone you care for has fallen ill suddenly.
You are in a serious automobile accident.
You are in a situation that involves the police.
Death.
If you miss an appointment, I will reach out twice via text and email with an attempt to reschedule. If you do not respond to these two attempts at contact, I will assume that you have dropped out of therapy and make the space available for another client. In this event, I will send you a discharge notice via email and close your chart.
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Client is out of the service area
If you show up for a scheduled appointment and it becomes apparent that you are not physically located in the state where I am licensed to practice, I will immediately terminate the appointment and there will be no refund.
Conduct issues
If you show up for your appointment in violation of the conduct policy, the session will immediately be terminated without refund and you may be discharged from my services.
Repeated no shows
After three no shows (missed appointments), you will be discharged from my services.
Illness or injury
In the event that I am ill or injured to the point that it is necessary for me to cancel our scheduled appointment, I will notify you by text and email, and I will make every effort to reschedule within the same week.
Life stuff
I may occasionally take time off for vacations, professional development, and health care. If these events occur on your regular appointment day or time, we can work out an alternate plan for that week. An alternate plan may involve taking a week off, rescheduling with me for a different day and time, or scheduling with one of my colleagues so you don’t go without care for that week. You will still be able to reach me by text or email on those days if you have a quick question.
I don’t take vacations often, but when I do, I will give you a month’s notice.
If I have to take time off for serious life stuff like a surgery or funeral, I will give you as much notice as I can.
To maintain my license, I attend continuing education workshops throughout the year. I go out of my way to find on-demand workshops so they do not interfere with my work schedule. However, there are sometimes live workshops I need to attend. I always know about these at least a month in advance, usually much further in advance.
Therapist no-show
If I do not show up for a scheduled appointment, there could be three possible reasons: I made an error; I am ill or incapacitated to the point of being unable to send a text or email; I am dead.
If I make an error, I will contact you as soon as possible to reschedule, and you will not be charged for the rescheduled appointment provided that the rescheduled appointment takes place within two weeks.
If I am incapacitated to the point where I could not text or email you prior to our appointment, I will contact you as soon as possible to reschedule and the regular fee policies will apply.
If I am dead, you will be contacted by one of my business associates and referred to another clinician.
Termination of Services
Reasons for Termination
Termination of the therapeutic relationship is guided by ethics. According to the American Counselors Association code of ethics (2014, A.11.c.), “Counselors terminate a counseling relationship when it becomes reasonably apparent that the client no longer needs assistance, is not likely to benefit, or is being harmed by counseling. Counselors may terminate counseling when in jeopardy of harm by the client or by another person with whom the client has a relationship, or when clients do not pay fees as agreed upon.”
The following are common reasons for termination of therapy:
Therapy no longer needed
Different level of care needed
Issues or goals are outside the therapist’s scope of practice
In-person therapy more appropriate
Harmful or inappropriate behavior
Violation of contract (i.e. informed consent agreement)
Outstanding balance
Ghosting
I may terminate services if it becomes apparent that you would best be served by a clinician who specializes in services in which I do not have the needed training or experience, or if you need a higher level of care than can be provided by a teletherapy or by a solo practitioner.
In the event that termination is appropriate, I will notify you in writing and provide referral resources.
Please refer to my counseling policies and procedures for guidance regarding conduct and financial obligations. You will be supplied with copies of these policies when we start working together.
Inactive Clients
If you stop scheduling sessions, repeatedly cancel appointments, or miss two sessions in a row with no contact, I will assume that you have decided not to continue therapy with me. I will attempt to contact you via text and email to confirm. If I do not receive a response within a week of these communications, I will change your status to inactive and send you a discharge notice via email.
If you are unable to contact me due to a medical emergency, institutionalization, or incarceration, please have your emergency contact reach out to me to let me know if possible. If you would prefer that I reach out to your emergency contact when I do not hear from you, this is something you will tell me during our first session when we establish an emergency management plan.