Booking Terms

Terms and Conditions

I, hereby consent to participate in counseling services provided by Interception Counseling Services, LLC and understand that the information discussed during our sessions will be kept confidential, with the following exceptions:

1. If there is suspicion of child abuse or dependent adult or elder abuse, the counselor is required by law to report this to the appropriate authorities.

2. If the client is a danger to himself/herself or others, the counselor may take steps to protect the client and/or others, which may include seeking hospitalization or contacting family members or other involved professionals.

3. If the client is involved in a court case and a subpoena is issued for the counselor's records or testimony, the counselor may be legally obligated to disclose certain information.

4. If the client is participating in couples or family counseling, the counselor may share information discussed in the session with the other members of the counseling session as deemed appropriate by the counselor.

5. I understand that any information shared with a supervisor or consultant for the purpose of professional training or consultation will also be kept confidential. I also understand that no guarantees can be made about the confidentiality of any information shared through electronic means such as email or text messaging.

I have the right to request that the counselor release specific information to a designated individual or organization and that I may revoke this consent at any time by providing written notice to the counselor.

Book now and Pay Later

I, understand that if I book a session online, I am obligated to the amount of $130 for the session or any out-of-pocket cost if covered under insurance for that session. 

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Cancellation Policy:

I, understand and agree that payment for counseling services provided by Interception Counseling Services, LLC is non-refundable. I understand that the services provided are for the scheduled session as agreed upon in advance, and that payment is due at the time of booking the session. I understand that if I miss a scheduled session, I will still be responsible for the full payment for that session. If I cancel a session with less than 24 hours’ notice, I will still be responsible for the full payment for that session. I understand that if I choose to terminate counseling services before the completion of the agreed upon number of sessions, I will still be responsible for the full payment for the remaining sessions. I understand that if I am unable to attend a scheduled session due to an emergency or extenuating circumstances, Interception Counseling Services, LLC will make every effort to reschedule the missed session within a reasonable time frame.

Online Counseling Session Acknowledgement:

A 15-minute intake process is required to gather demographic information and sign up for our Electronic Health Record system. Additional forms must be signed before proceeding with the session. Assessment, diagnosis, and treatment plan information will be documented and added to our Electronic Health Record.

State of Arizona:

I acknowledge that I am a resident, residing, living and physically located in the State of Arizona.