Please read the following information carefully. It is your responsibility to understand the conditions of establishing a counseling agreement prior to entering into the counseling relationship. Continuing into the counseling relationship, is considered your acceptance and understanding of these terms. Should you have any questions concerning this agreement, please call or e-mail my office.
Pamela Milam, MA, LPC, is established as an individual in private counseling practice in the city of Dallas, Texas. Primary ethical responsibilities and obligations are to the Licensed Professional Counselor's Board of the Department of Health in the State of Texas. Ethical responsibilities are also recognized through membership in the ACA. For purposes of this agreement, Pamela Milam, MA, LPC will be referred to as "counselor" and the individual seeking counseling services will be referred to as "client".
All clients engaging in any form of counseling relationship, must be 18 years of age or older, unless accompanied by a parent during the initial meeting.
All communications are conducted in a private setting and held in strict confidence. Information shared can not be released by the counselor to anyone except for the follow exceptions: (1) A client reveals the thoughts or plans to harm themselves or others. (2) Reveals any situation that may be considered abuse or danger to a child or elderly individual. (3) Any legal issues involving the client that results in demand for information as per a court order, (4) With clients written consent.
Security of Telephone
The telephone will be used to collect personal information, should the client not wish to disclose this through e-mail. Telephone counseling services are provide utilizing standard telephone equipment and services. Client agrees to provide counselor with the telephone number they wish to utilize for this service. The call will be made at the scheduled session time. Client holds responsibility for establishing a comfortable environment for themselves, without risk of interruptions or distractions. Client is also asked to disengage telephone features such as call waiting and call block for the session time.
Limitations Of Services:
|Online and Telephone Counseling may not be the most appropriate modes of counseling services for certain situations or individual issues.|
|Clients in an emergency situation or crisis, and/or experiencing thoughts of suicide, self harm or harming others, must call 911 immediately.|
|Clients with situations involving serious mental health issues requiring intense psychotherapy must seek an individual office counseling session.|
Before entering into
a counseling relationship, client agrees to a brief evaluation
of needs, and will enter into the agreed mode of counseling
services at their own risk.
Prior to setting an appointment, each client must provide as much information as possible, so counselor may briefly evaluate clients needs. This can be done by telephone or e-mail. The purpose is to establish the client's needs and appropriate mode of services. There is no charge for this exchange of information.
Fees are to be paid prior to services provided. (1) Checks or cash or credit card may be used as payment for office visits. Credit card payments must be made utilizing the "Online Payment" option in this web site. (2) Credit card may be used for online counseling services by also utilizing the Online Payment option.
The client is asked to self-pay and file with his/her insurance company for reimbursement. Responsibility for payment rests with the client.
Missed or Canceled
Client agrees to cancel appointments at least 24 hours in advance. Clients not giving proper cancellation notice, will be charged a $50.00 fee for each missed appointment.
Refunds will be given for the following reasons:
|Client gives at least 24 hours notice to cancel prepaid appointment.|
|Counselor fails to keep the appointment.|
|All refunds will be made by money order, mailed to client within seven days. Due to the security of the credit card payment program, counselor cannot access your card information for a refund to your card.|
One of the disadvantages of utilizing telephone and computer/Internet technology is the unforeseen equipment failure. Should client or counselor lose connection during an online session, both will attempt to reconnect immediately. No charges are accrued during this reconnect time. Should reconnection not be immediately possible, the time remaining for your session will be credited to another session time. Counselor does not accept responsibility for any technical difficulties that could occur. Should technical failure prohibit an online session, alternative arrangements or another scheduled session will be made.
Online Payment Option:
Online payment for credit card use is very simple. Client clicks the Paypal's icon on the Online Payment page of this web site and follow the directions. Online payment is provided through "PayPal", an online payment company. If client has not used this service in the past, they will be asked to complete a one time information form. Counselor does not have access to this information. When client makes payment, the counselor is notified by e-mail of receipt of the payment. Counselor contacts client with confirmation of payment and arrangements for scheduled session time. Paypal reports their sites and service to be secured. Please read their agreement carefully. Client accepts full responsibility of choosing the use of "Paypal". Counselor is not responsible for any actions, errors, or failures made by "Paypal". Any questions concerning the Paypal system may be directed to Paypal.com.
Occasionally the client may need additional services not offered by counselor. Counselor will provide client with referrals if possible. However, client holds the responsibility and risk for contacting and accepting these services and their outcomes.
Termination of Services:
Client or counselor may choose to terminate the counseling relationship at any time. The party choosing to terminate the relationship, agrees to contact the other party through e-mail or written letter, with reasons for termination. Client may choose to terminate the counseling relationship at anytime. Counselor may terminate relationship if they feel the client has reached their goals, the client is not progressing under the counselors care, or the counselor is not qualified to provide the services needed at this time. Counselor agrees to provide client with referrals for more appropriate services should this be needed.
By making arrangements to use the counselor’s services, you are agreeing to all conditions stated in this policy.