Dear Patients:

I feel that I am best able to serve you if you are aware of my office practices. Please read over the following and sign two copies, keeping one for your records.

EVALUATIONS: In order to develop a treatment plan that we can all agree upon, I have found it most productive to begin treatment of children and adolescents, and often adults, after an evaluation period. Critical information collected will include strengths, interests and challenges; goals and priorities; what works, what doesn't; critical people in the client and family support system; and past response to medications and alternative treatments.

CONFIDENTIALITY: All communications between adult clients and myself are kept strictly confidential. Communications between child and adolescent clients and myself are kept relatively confidential, as I explain to children and adolescents that I will have some contact with their parents. In order to maintain trust with adolescents, I provide them with an oral summary of all conversations and emails with parents, and when appropriate share email. There are, however, two exceptions to confidentiality:

If I am convinced that the client will do harm to him or herself, or to someone else, I am required by law to take appropriate measures to assure the safety of the client or the safety of anyone else who is threatened.

If a client reveals child abuse (sexual, physical, or emotional), I am required by law to report such matters to the Child Protective Services or the appropriate authorities.

EMERGENCY PROCEDURE: If you are in crisis and need emergency assistance, contact me at 570.6749. If you are unable to reach me, please call 911 or go to the nearest emergency room.

CANCELLATIONS: The appointment time has been reserved for the patient. Subsequently, missed appointments and non-emergency last minute cancellations with less than 24 hours notice will be billed.

APPOINTMENTS AND FEES: The fee for the first one and a half hour consultation is $600.  Ongoing fifty-minute psychotherapy sessions are billed at $350 per session. Fifty-minute psychopharmacology sessions are billed at $350 per session.  Twenty-five minute psychopharmacology sessions are billed at $250 per session.

While there is no cost for short phone calls, phone calls over 10 minutes are billed proportional to my rate of $350/hour.

INSURANCE: I require that patients pay their entire bill and then be reimbursed by the insurance company.

DELINQUENT ACCOUNT POLICY: Unpaid accounts are forwarded to a collection agency.

copyright ゥ Neal Mazer, MD, MPH