Practice Policies

Confidentiality Policy

At Ebb & Flow Wellness, PLLC, your privacy is a top priority. What you share in therapy is personal and deserves to be treated with respect and care. This confidentiality policy explains how your information is protected and the situations where your information may be shared.

Everything you discuss during therapy sessions is kept private and confidential. This includes:

  • Session content and notes

  • Your identity and participation in therapy

  • Any records we maintain

Your records are securely stored and only accessible to your therapist unless you provide written consent.

There are specific legal and ethical situations where I am required to break confidentiality:

  1. Risk of Harm: If you express intent to seriously harm yourself or someone else, I am obligated to take steps to protect you or others, which may include notifying emergency contacts or authorities.

  2. Suspected Abuse or Neglect: If I suspect abuse or neglect of a child, elder, or dependent adult, I must report it to the appropriate protective services.

  3. Court Orders: If a court of law requires disclosure of records or testimony, I may be legally obligated to comply.

  4. Medical Emergencies: In a medical emergency, relevant information may be shared with healthcare providers to ensure your safety.

Online sessions are conducted through a secure, HIPAA-compliant platform. I recommend that you participate from a private location where others cannot hear your session.

Informed Consent

Therapy is a collaborative process designed to help you explore emotions, heal from past experiences, and develop skills to manage life’s challenges. The goal is to support your emotional well-being and personal growth.

While therapy can be deeply rewarding, it may also bring up difficult feelings. That’s a normal part of the healing process, and I will support you every step of the way.

By beginning therapy services, you acknowledge that:

  • You understand the nature and limits of therapy.

  • You have had the opportunity to ask questions.

  • You consent to participate voluntarily in therapy with Ebb & Flow Wellness, PLLC.

Late Arrival Policy

Please review the following guidelines regarding late arrivals:

Client Late Arrival:
If you arrive late to your scheduled session, the session will still end at the originally scheduled time to honor the schedules of other clients. You will be responsible for the full session fee, even if you are late. If you are more than 15 minutes late without prior notice, the session may be considered a no-show and may be canceled.

Therapist Late Arrival:
If I am running late, I will notify you as soon as possible and ensure that you receive your full session time, if feasible, or offer options to reschedule or extend time as appropriate.

Timely attendance helps support the flow of therapy and respect for each other's time.

Cancellation and No-Show Policy

At Ebb & Flow Wellness, PLLC, your time and well-being are important—and so is mine. In order to provide consistent care and honor both of our schedules, the following policy applies to all therapy appointments.

If you need to cancel or reschedule an appointment, please provide at least 24 hours’ notice. This allows me to offer the time to another client who may be waiting.

  • Clients who no-show or late cancel (less than 24 hours’ notice) three times within a six-month period may be subject to termination from services. Consistent attendance is essential for therapeutic progress, and repeated missed appointments impact the ability to provide quality care.

  • You can cancel or reschedule by via phone, email, or Simple Practice client portal.

  • Cancellations made with less than 24 hours’ notice will be considered late cancellations.

  • Late cancellations and missed appointments (no-shows) will be charged the full session fee unless due to an emergency or serious illness.

  • Insurance does not cover missed or late-canceled sessions. You will be responsible for this fee.

Life happens. If you miss an appointment for the first time, I will reach out to check in and offer an opportunity to reschedule. After the first missed session, the standard fee will apply for future late cancellations or no-shows. If missed appointments become frequent or inconsistent attendance begins to interfere with your progress in therapy, we may need to reevaluate your readiness for services or adjust your treatment plan.

Payment and Fees Policy

At Ebb & Flow Wellness, PLLC, I believe in transparency and accessibility when it comes to the financial aspects of therapy. Below you’ll find important information about session fees, payment options, and related policies.

  • Individual therapy sessions (45–60 minutes): $125 per session

  • Intake/initial consultation (60 minutes): $150 per session

Fees are subject to change. Any rate changes will be communicated in writing in advance.

A limited number of reduced-fee spots are available for clients who demonstrate financial need. Please inquire if this is something you’d like to explore.

  • If your balance exceeds two unpaid sessions, services may be paused until payment arrangements are made.

  • Communication is key—please reach out if you’re experiencing financial hardship.

Communication Policy

At Ebb & Flow Wellness, PLLC, I value open, respectful communication. This policy outlines how you can contact me between sessions and what to expect in terms of response time and communication boundaries.

You may contact me in the following ways:

  • Phone: 704-770-6489

  • Email: hello@ebbandflowwellness.org

  • Client portal: For secure messaging, scheduling, or sharing documents through Simple Practice

Please note: Email and text messages are not appropriate for discussing clinical issues or emergencies.

  • I will respond to messages within 24 business hours (Monday–Friday).

  • I do not check messages on weekends or holidays.

  • If you reach out after hours, I will get back to you during the next business day.

  • Communication between sessions should be brief and limited to logistics (scheduling, paperwork, etc.).

  • Clinical matters are best discussed during sessions to maintain the depth and safety of the therapeutic space.

  • Texting is optional, and I do not conduct therapy via text.

Emergency and Crisis Policy

If you are experiencing a mental health crisis, are at risk of harming yourself or others, or are in any immediate danger, please use one of the following options:

  • Call 911 or go to your nearest emergency room

  • Call or text 988 to reach the Suicide & Crisis Lifeline (available 24/7)

  • Contact your local crisis center or mobile crisis unit

  • Text "HOME" to 741741 to reach the Crisis Text Line

    If you have a history of crisis situations, we may create a safety plan together that includes coping tools, emergency contacts, and community resources.

    Messages sent to me by email, phone, or client portal during a crisis may not be seen or responded to in time. Please use emergency services if you are in immediate danger.

Termination Policy

Ending therapy is a significant part of the healing process. At Ebb & Flow Wellness, I am committed to supporting you through every phase of our work together, including the transition out of therapy.

Termination may occur for a variety of reasons, and it is my goal to make this process as thoughtful, respectful, and supportive as possible.

Client-Initiated Termination

You have the right to end therapy at any time. I encourage you to bring up the desire to pause or stop therapy so we can:

  • Reflect on your progress

  • Discuss next steps or maintenance strategies

  • Ensure a respectful closure to our work

Even if therapy ends suddenly, I’m available for a final session to offer closure and resources if needed.

Therapist-Initiated Termination

In some cases, I may determine that it is appropriate to end therapy. This could happen if:

  • You have achieved your goals and no longer need support

  • You are frequently missing or canceling sessions, making therapy ineffective

  • Your needs fall outside of my scope of practice or expertise

  • There is a conflict of interest or ethical concern

  • Payment for services is not being received despite attempts to address it

In such cases, I will discuss my concerns with you and, when possible, offer referrals to help you continue care elsewhere.

Mutual Termination

Sometimes, we may mutually agree that therapy has run its course or that a break is needed. This decision is best made collaboratively and with space to reflect on what you’ve gained from therapy.

Emergency or Involuntary Termination

In rare cases—such as a breach of safety, harassment, or unethical behavior—termination may occur immediately. If this happens, I will provide written notice and, if appropriate, referrals to alternative care.

PRIVACY POLICY

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

I. MY PLEDGE REGARDING HEALTH INFORMATION: I understand that health information about you and your health care is personal. I am committed to protecting health information about you. I create a record of the care and services you receive from me. I need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by this mental health care practice. This notice will tell you about the ways in which I may use and disclose health information about you. I also describe your rights to the health information I keep about you, and describe certain obligations I have regarding the use and disclosure of your health information. I am required by law to:

  • Make sure that protected health information (“PHI”) that identifies you is kept private.

  • Give you this notice of my legal duties and privacy practices with respect to health information.

  • Follow the terms of the notice that is currently in effect.

  • I can change the terms of this Notice, and such changes will apply to all information I have about you. The new Notice will be available upon request, in my office, and on my website.

II. HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU: The following categories describe different ways that I use and disclose health information. For each category of uses or disclosures I will explain what I mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways I am permitted to use and disclose information will fall within one of the categories.

For Treatment Payment, or Health Care Operations: Federal privacy rules (regulations) allow health care providers who have direct treatment relationship with the patient/client to use or disclose the patient/client’s personal health information without the patient’s written authorization, to carry out the health care provider’s own treatment, payment or health care operations. I may also disclose your protected health information for the treatment activities of any health care provider. This too can be done without your written authorization. For example, if a clinician were to consult with another licensed health care provider about your condition, we would be permitted to use and disclose your personal health information, which is otherwise confidential, in order to assist the clinician in diagnosis and treatment of your mental health condition.

Disclosures for treatment purposes are not limited to the minimum necessary standard. Because therapists and other health care providers need access to the full record and/or full and complete information in order to provide quality care. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between health care providers and referrals of a patient for health care from one health care provider to another.

Lawsuits and Disputes: If you are involved in a lawsuit, I may disclose health information in response to a court or administrative order. I may also disclose health information about your child in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:

  1. Psychotherapy Notes. I do keep “psychotherapy notes” as that term is defined in 45 CFR § 164.501, and any use or disclosure of such notes requires your Authorization unless the use or disclosure is: a. For my use in treating you. b. For my use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling or therapy. c. For my use in defending myself in legal proceedings instituted by you. d. For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA. e. Required by law and the use or disclosure is limited to the requirements of such law. f. Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes. g. Required by a coroner who is performing duties authorized by law. h. Required to help avert a serious threat to the health and safety of others.

  2. Marketing Purposes. As a psychotherapist, I will not use or disclose your PHI for marketing purposes.

  3. Sale of PHI. As a psychotherapist, I will not sell your PHI in the regular course of my business.

IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION. Subject to certain limitations in the law, I can use and disclose your PHI without your Authorization for the following reasons:

  1. When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.

  2. For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.

  3. For health oversight activities, including audits and investigations.

  4. For judicial and administrative proceedings, including responding to a court or administrative order, although my preference is to obtain an Authorization from you before doing so.

  5. For law enforcement purposes, including reporting crimes occurring on my premises.

  6. To coroners or medical examiners, when such individuals are performing duties authorized by law.

  7. For research purposes, including studying and comparing the mental health of patients who received one form of therapy versus those who received another form of therapy for the same condition.

  8. Specialized government functions, including, ensuring the proper execution of military missions; protecting the President of the United States; conducting intelligence or counter-intelligence operations; or, helping to ensure the safety of those working within or housed in correctional institutions.

  9. For workers’ compensation purposes. Although my preference is to obtain an Authorization from you, I may provide your PHI in order to comply with workers’ compensation laws. 10 Appointment reminders and health related benefits or services. I may use and disclose your PHI to contact you to remind you that you have an appointment with me. I may also use and disclose your PHI to tell you about treatment alternatives, or other health care services or benefits that I offer.

V. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT.

  1. Disclosures to family, friends, or others. I may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.

VI. YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:

  1. The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask me not to use or disclose certain PHI for treatment, payment, or health care operations purposes. I am not required to agree to your request, and I may say “no” if I believe it would affect your health care.

  2. The Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full. You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full.

  3. The Right to Choose How I Send PHI to You. You have the right to ask me to contact you in a specific way (for example, home or office phone) or to send mail to a different address, and I will agree to all reasonable requests.

  4. The Right to See and Get Copies of Your PHI. Other than “psychotherapy notes,” you have the right to get an electronic or paper copy of your medical record and other information that I have about you. I will provide you with a copy of your record, or a summary of it, if you agree to receive a summary, within 30 days of receiving your written request, and I may charge a reasonable, cost based fee for doing so.

  5. The Right to Get a List of the Disclosures I Have Made.You have the right to request a list of instances in which I have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided me with an Authorization. I will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list I will give you will include disclosures made in the last six years unless you request a shorter time. I will provide the list to you at no charge, but if you make more than one request in the same year, I will charge you a reasonable cost based fee for each additional request.

  6. The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that I correct the existing information or add the missing information. I may say “no” to your request, but I will tell you why in writing within 60 days of receiving your request.

  7. The Right to Get a Paper or Electronic Copy of this Notice. You have the right get a paper copy of this Notice, and you have the right to get a copy of this notice by e-mail. And, even if you have agreed to receive this Notice via e-mail, you also have the right to request a paper copy of it.