60 minute Individual Therapy

Cancellation Policy

Investment of Services and Fees: Please view the attached ‘Session Fees’ to understand your financial responsibility for your therapy sessions as a part of the ‘No surprises Act’. Financial Responsibility: I understand by signing this consent form that IAM Enroot Therapy is a private pay concierge practice and I agree to pay all session fees prior to my scheduled session. I understand that I am opting out of insurance but can receive a superbill for out of network reimbursement upon request. Billing: Iam Enroot Therapy keeps a credit card on file through our business partner Ivy Pay and will charge your card within 24 hours prior to your session. Any insurance reimbursement should be arranged between you and your insurance company and you can request a superbill from the practice via email at anytime. Please note; insurance reimbursement including how much reimbursed and approval of reimbursement is determined by your specific plan, is between you and your insurance provider and is clients responsibility. Cancellations: It is important that clients cancel via email at admin@iam-enroot-therapy.com 24 hours in advance if you find you cannot make your appointment. You will be charged for missed sessions and all appointments that are not canceled prior to the session. Consent to Treatment Via Telehealth: I consent to participate in telemental health services. I understand that I have the right to refuse telemental health services and be informed of alternative services that may be available to me. If I request alternative services, I understand that IAM Enroot Therapy may not be able to provide those services, and that I may experience delays in service, the need to travel, or any other risks associated with not having services provided via telemental health, as well as risks associated with receiving telemental health services in an off-site location. I understand that telehealth may result in certain risks that are less likely to occur with in-person services, such as technology failure, need for specialized electronic security systems, and less visibility of non-verbal cues. Telehealth can also provide benefits not present with in-person services, such as creating greater flexibility for when and where services may be provided.

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