Therapy 

It is my expectation that you will benefit from psychotherapy, but there is no guarantee. Therapy is conducted either in-person in one of my offices, online with interactive video, or via telephone.

Confidentiality

The information you disclose during the course of therapy is confidential. However, there are legal exceptions for reporting, both mandatory and permissible when there is a threat of harm to self or others, or if ordered by a court through legal process. 

Fees and Terms

My fee for a 55 minute in-person, video or phone session for individuals, couples or families is shown below.

For in-person sessions: The full fee must be paid at the beginning of each session. I reserve the right to invoice you for the full fee if you cancel an in-person session with less than 48-hours advance notice.

For online or phone sessions: You will receive an invoice electronically when you schedule the session. The full fee must be paid at least 24 hours before the start of the scheduled session or it will be automatically cancelled. You may cancel the session with 24 hours prior notice and receive a full refund. No cancellations will be accepted within 24 hours of the scheduled time.

By signing this form below I agree to the following:

1. I or one of my family members being counseled resides in the state California.
2. I have reviewed the legally-required “HIPAA Notice of Privacy” and "Good Faith Estimate" notices available online at loriconroy.com/forms.
3. (If  you are 65 years old or older) By signing below I have reviewed and agree to the terms outlined on the "Self Pay (Opt Out) of Medical Services" form posted on my website at loriconroy.com/forms.
4. If consenting to couples or family therapy I understand that there is no confidentiality between clients, and if I reveal information to my therapist Lori Conroy, LMFT, she may disclose that information if she feels it is in the best interest of the family.
5. I agree to participate in psychotherapy with Lori Conroy, LMFT. I have read, understood and agree to comply with the agreed upon policies and the Per-Session Rate shown below.