Marcy Abramsky, LCSW

Therapy / Coaching

Coaching AbramskyInspireAmindCoach.com
Please see this website for this service above – Master Life Coach Training 

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Therapy
InspireAmind.net

My office operates in full compliance with HIPPA (Health Insurance and Portability Accountability Act) regulations, which were designed to provide a high level of confidentiality and protection regarding your health information.

The following privacy policy applies to the use of this website:

My practice does not sell, rent, trade or otherwise disseminate externally any personal information about those visiting his web site. We do reserve the right to use the information for internal tracking and statistical analysis, including but not limited to determining the number of visitors to the site, analyzing which sections are most accessed, length of stay per visitor and number of repeat visits.

Usage Rules

By continuing to browse my web site, you agree not to use any information obtained for any purpose that is illegal, unlawful, unethical or prohibited by copyright or this agreement.

By continuing to browse the site, you also expressly agree that you do so at your own risk.

Links to other Web Sites

As a convenience to visitors, we may provide links to web sites operated by other organizations. Such links do not imply or convey endorsement of said organizations. Further, these organizations are not covered under this agreement and are solely responsible for the content, security, terms of use and privacy issues of their web sites. We are absolved from responsibility for any repercussions experienced on other linked web sites.

Additionally, Marcy Abramsky, LCSW InspireAmind®️ privacy policy shares that Marcy Abramsky, LCSW and this website provider are committed to protecting your privacy. This written policy is to explain the online information practices followed. To make this notice easy to find it is available on my website.

Collection of Information
Any information collected about visitors to the Site is a standard practice to enhance the experience responsiveness to each users’ and customers’ needs. No medical information or credit card information is collected through the Site. All PHI (Patient Health Information)is shared through HIPAA secure means. In addition,  for the protection of your information, this site redirects any information secure encrypted email prior to becoming a client.* please see informed consent for consult page.. To be even safer, you should free to use the HIPAA compliant email provided separately or the phone number.
By using those methods to request an appointment or to obtain further information, is easier to have less contact within the website.

Marcy Abramsky, LCSW will not sell, share, trade or otherwise use any medical information ( PHI) under any circumstances*.

*Circumstances that require exceptions regarding client confidentiality

 Duty to Warn~ If someone is an imminent threat to another individual. The courts have established an LCSW has a “duty to warn”. This carries a legal obligation to warn the potential victim.

 Duty to Protect~ This means an LCSW may need to take further steps to prevent a potential victim from harm.

 According to the Code of Ethics of the National Association of Social Workers (NASW) “Social workers should protect the confidentiality of all information obtained in the course of professional service, except for compelling professional reasons.

If you have any concerns regarding confidentiality, please feel free to speak to me about this.

A HIPAA policy and notice of your rights will be shared with you. If at any time you require information from our sessions, please request it directly.
A Records Release form, via portal or other will be provided to you. Simply return the release form filled out back to (me) Marcy Abramsky, LCSW. Your records may be returned much faster, but please allow 7 -10 business days from the date the release was received. You will get a response that I have received your request.

Non-personally identifiable information about you, may be collected, such as your use of the website, communication preferences, aggregated data relative to your services. This aggregate information may be disclosed only where no individual is identified for a number of purposes, including: (a) Compiling aggregate statistics of usage for improving the web site; (b) Developing, maintaining and administering the web site; and (c) Following up on comments and other messages that you submit to us through the web site. Please note, to better safeguard your information, please do not include any credit card information in your electronic communication unless it is through the portal.
This Site and our Services may contain links to other websites.* see the above notice regarding those sites.

SECURITY

This Site has security measures in place to protect against the loss, misuse or alteration of the information under our control. All information you send initially is through encrypted email. Your calls and emails can only go to Marcy Abramsky, LCSW on devices with a VPN (private network). The data you share through the portal or secure email is encrypted. The encryption uses a secure socket layer technology (SSL). We follow generally accepted standards and more to protect the personal information submitted to us, both during transmission and once we receive it.

Informed Technology Use *Security

However, please be aware that no method of transmission over the Internet, or method of electronic storage, is one hundred percent (100%) secure. Therefore, nobody can guarantee it’s absolute security. However, all the above steps are in place for your security, as it is vital to Marcy Abramsky, LCSW.

GOOGLE ANALYTICS AND COOKIES and disabling cookies

On the website, “Google Analytics” may be used to collect information about use of this Site, regarding visitors to the Site, the pages they visit, when they do so, and what other sites they visit prior to this Site. Google Analytics only collects IP address assigned to you on the date you visit this Site, instead of your name or other identifying information. Google Analytics plants a permanent cookie on your web browser to identify you as a unique user the next time you visit this Site. This cookie cannot be used by anyone but Google, Inc. The information generated by the cookie is sent to and stored by Google on servers in the United States. The information received from Google Analytics is used to improve services on this Site. The information collected using Google Analytics is never combined with personally identifiable information. Google’s ability to use and share information collected by Google Analytics about your visits to this Site is restricted by the Google Privacy Policy http://www.google.com/policies/privacy.
You can prevent Google Analytics from recognizing you on return visits to this Site by disabling the Google Analytics cookie on your browser.

COLLECTION OF PERSONAL INFORMATION

All consent and information you would use after the website InspireAmind.net, is your choice and directed to one secure mailbox, or private phone/voicemail passcode protected, with all devices under a private VPN secure network.
To begin, a HIPAA secure email service was created, to encrypt personal data for use such as therapy, medical and other private health business, and safety matters. A (BAA) or Business Associates Agreement has also been obtained between the email service provider, and Marcy Abramsky, LCSW. A BAA, was also provided with the practice management program (you would use as a client) responsible for communication and where you are uploading documents and video calling technology for your protection. BAA’s have been obtained with any other parties that supports the work of Marcy Abramsky, LCSW.

EXTRA TECHNOLOGY SAFEGUARDS

This technology was chosen for you, ater testing several options. This provides extra layers of protection, when using the email listed on the website for initial or any direct communication with Marcy Abramsky, LCSW. Please be aware that nothing is 100 percent perfect, this service provides multiple layers of security, and end to end encryption. Even, the service providers do not have access to the emails, or passwords, if lost. The fact that the businesses are working together with Marcy Abramsky, LCSW and will sign a BAA, is even a greater sign of their faith in the security of their network. This company has also been well researched for you.

Client Portal

After initially visiting InspireAmind.net, or using the secure email provided, most everything after that  (i.e. appointment scheduling, uploading of documents etc.and more) can be done via phone, in sessions, or exchanged, completed and obtained through the Client Portal. This portal is designed specifically for maintaining secure
(EHI) Electronic Health Information.
All clients have access to this, and it is used for personalized private links for online sessions, and payment. As long as you, the client are in a safe space, your information has a lot of protection. For all clients, forms (consent, registration, worksheets etc.) will be available to you through the portal. Information on how your credit card is securely stored through the portal and practice management program, will be shared there as well. The only information that would be shared about you is what is necessary for the third party to provide the requested service for payment. These companies are prohibited from retaining, sharing, buying, selling, storing or using your personally identifiable information for any secondary purposes. Sessions can be changed, and support is offered in between sessions, there as well! There is more information on the portal regarding security as well.

CHILDREN UNDER AGE 18

I am committed to protecting the online privacy of children. I will not knowingly collect any personally identifiable information from children under the age of (18) without first obtaining parental consent. A parent or legal guardian must complete a Parental Consent Form via the secure portal or secure email InspireAmind@protonmail.net and be seen by Marcy Abramsky, LCSW on the Initial Video Session. The parent must upload their ID. The consent form states that the child’s “Parent” or “Legal Guardian”, by his or her signature, consents to the collection and transfer of the child’s personally identifiable information. Consent may be revoked by completing a form via the HIPAA compliant portal, or secure email: InspireAmind@protonmail.com .

*As per the guidelines on internet advertising, I am mindful regarding solicitation to minors. I encourage parents/guardians to supervise and join their children in discovering information through internet use. In New York State, a minor is defined as a person under the age of 18. Therefore, I do not provide therapy / counseling (online) to minor children under the age of 18, without parental consent. Marcy Abramsky, LCSW, abides by Public Health Law §2504, which identifies that a person who is eighteen years or older may give consent for their health care. Thank you for respecting this policy.

HIPAA Disclosures to Law Enforcement

HIPAA privacy rules 45 CFR 164.501 generally prohibit healthcare providers from disclosing protected health information to police and other law enforcement officials without patient/client written authorization, unless under certain conditions.

-Court Order, Warrant, Subpoena

-Imminent Harm

-Required by Law (Child Abuse, Neglect or Maltreatment) *Comply with strict terms of the law- do not disclose more than is required by law.

-Identify Person Must be in response to specific request

-Victim of a Crime (Requires a lot of other consents or conditions)

-Death (having resulted of a crime)

-Criminal Conduct on Premises

-Report by Victim

-Admission of Violent Crime (not made in the course or based on the individuals request for therapy related to their propensity to commit this type of violent act In all cases, provider (Marcy Abramsky, LCSW) is looking for the safety of the client, the community, and most restrictive disclosure that covers the request by law, or necessary to meet these objectives.

To the extent I ( Marcy Abramsky, LCSW) am legally permitted to do so, I will take reasonable steps to notify you, and request consent in the event that we are required to provide your personal information to third parties as part of legal process.

Changes in Policies and Practices

Marcy Abramsky, LCSW reserves the right to modify this Privacy Policy at any time. If there is a change to the Privacy Policy, it will be posted to this Privacy Policy and, you will be made aware of alterations in information collected, under what circumstances, if any, it is disclosed.

CORRECTING, UPDATING AND REMOVING PERSONAL INFORMATION

You may alter, update or deactivate your account information or opt out of receiving communications at any time, so long as you have connected and paid the remainder of any prior outstanding payment. You may send an email to InspireAmind.net@protonmail.com or through the portal or call Marcy Abramsky, LCSW.
You will receive a response to your request for access or to modify or deactivate your information promptly, but within thirty (30) days. The portal will give you information on this as well. Feel free to call, for faster service. Your portal will be deactivated shortly upon an agreed upon or counselor termination of service as well.

MEDICAL PRIVACY NOTICE

This Section describes how medical information about you may be used and disclosed. How you also, may gain access to this information. Please review it carefully.

A. Who Will Follow This Notice?

Health care practitioners who you sign consent for. Health care practitioners, local medical, psychiatric, or emergency contacts (provided by YOU) who require minimal information in an emergency for safety reasons.

B. Your Medical Information

This Section refers to your “medical information”. This means all information that identifies you and relates to your past, present or future physical or mental health or condition including information about payment and billing for the health care services you receive. C. Pledge Regarding Medical Information – Your medical information is personal and we are committed to its protection. We create a record of the care and services you receive to ensure that we are providing quality care and to comply with legal requirements. This notice applies to all your medical information that we maintain, whether created by me or others. It is required by law to give you this notice of the legal duties and privacy practices with respect to your medical information, to follow the terms of this Privacy Notice, and to notify you following a breach of the privacy or security of your unsecured medical information. D. How We May Use and Disclose Medical Information About You. For each category of use and disclosure, we will try to give some examples, although not every use or disclosure in the category will be listed. i. For treatment. Your medical information may be used so that in partnership with other health care providers you be provided with medical treatment or services. Different health professionals may also share your medical information in order to coordinate the different services you need. Your medical information may be disclosed to people outside of this office and/or locations who may be involved in your medical care after you leave care. Typically, it is the least amount shared that supports your health.

ii. For Payment. Your medical information may be disclosed so that treatment and services you receive may be billed to a third party, if I am a provider that they consider participating.. For example, your health plan may need to know about treatment you received so they will pay for the services provided. Your medical information may need be disclosed to the insurance company to obtain prior approval from your health plan (if I am in network or you have asked for out of network with my billing company)

iii. For Healthcare Operations Purposes. Your medical information may be used and disclosed for internal operations, such as business management, and administrative activities, legal and auditing functions, and insurance-related activities ( if that applies). Your medical information may be used for quality assurance. For example, reviewing my processes or evaluating my performance or techniques. I may also disclose information to doctors, nurses, techs, or students in training. All identifying information would be removed so others may use it to study healthcare and healthcare delivery without learning a specific patient’s identity.

iv. Health Information Exchange. It is possible that if  participating in Regional Health Information Organization (“RHIO”) which arranges for the electronic exchange of health information among health care providers in the state where we are located, your health information maybe electronically exchanged through RHIO for the purposes described in this Notice. You have the right to request that your information not be included in this exchange.

v. Individuals Involved In Your Care or Payment of Your Care. The release of your medical information may be allowed to a friend or family member who is involved in your medical care, or to someone who helped pay for your care. This may apply more in a custodial arrangement / guardianship.

vi. Notification. We may release your medical information to notify a family member, personal representative or another person responsible for your care of your location, general condition, or death. We also may release your medical information for certain disaster relief purposes.

vii. Contacts. We may contact you to provide appointment reminders, information about treatment alternatives, or other health related benefits and services that may be of interest to you.

viii. Worker’s Compensation. We may release medical information about you for worker’s compensation or similar programs, which provide benefits for work related injuries or illnesses. These cases may not apply to this professional.

ix. Mental Health Information. State laws create specific requirements for the release of mental health records. We will obtain your specific authorization to release mental medical information when required by these laws.

x. Drug & Alcohol Treatment Records. Specific rules apply to the release of certain drug and alcohol program records, and we will obtain your specific authorization to release those records as required by Federal regulation 42 CFR, Part 2. This may also not apply to services with this professional. 

xi. Miscellaneous. Your medical information may be used or disclosed without your prior authorization for several other reasons. Subject to certain requirements, we may give out your medical information without prior authorization for public health purposes, abuse or neglect reporting, health oversight audits or inspections, research studies, funeral arrangements, Coroner’s investigations, organ donation, and emergencies. We also may disclose medical information when required by law in response to a request from law enforcement in specific circumstances, for specialized government functions including correctional, military or national security purposes, in response to valid judicial or administrative orders or to avoid a serious health threat. Additional specific rules may apply to mental health records.

xii. Other Disclosures. Other uses and disclosures not described above will be made only with your written authorization. For example, we require your signed authorization for uses and disclosure that constitute the sale of your medical information and for most uses and disclosures of psychotherapy notes. Additionally, we will not use or disclose your medical information for marketing purposes unless we have a signed authorization from you except that an authorization will not be required if (a) a communication occurs face-to-face; (b) consists of marketing gifts of nominal value. You may revoke your authorization at any time unless we have relied on your authorization or your authorization was required as a condition of obtaining health care services.

E. Your Rights Regarding Medical Information About You

i. Right to Inspect and Copy. In most cases you have the right to inspect or receive a copy of your medical information (or have a copy provided to an individual whom you designate) when you submit a written request. If your medical record is maintained electronically in a designated record set, you have the right to request a copy of the information in an electronic form and format. We may deny your request in certain circumstances. If you are denied access to your medical information, you may appeal.

ii.Right to Amend. If you believe the information in your record is incorrect or incomplete, you have the right to request an addendum be added to your record by submitting a written request giving your reason. We may deny your request under certain circumstances. If we deny it, we may advise you in writing of the reason or explain your rights to submit a statement of explanation.

iii. Right to an Accounting of Disclosure. You have the right to a list of those instances where we have disclosed your medical information other than for treatment, payment, healthcare operations, or where a disclosure was specifically authorized., for the Hospital’s directory, to persons involved in your care, and certain other limited situations. To request an accounting of disclosures, you must submit a written request.

.iv. Right to a Paper Copy of this Notice. If this notice was sent to you electronically you have a right to a paper copy of this notice. You may request that we send other communications of protected health information by alternative means, or to an alternative location. This request must be made in writing to the person listed below in Section 13. We are required to accommodate only reasonable requests. Please specify in your correspondence exactly how you want us to communicate with you; and if you are directing us to send it to a particular place, the contact/address information.

v. Right to Request Restrictions. You may request in writing that we not use or disclose your medical information except when specifically authorized by you, when required by law, or in an emergency. Except in the case of certain requests related to disclosures to health plans, we are not required by law to agree to your request, but we will consider the request. We will inform you of our decision.

vi. Right to Request Restrictions on Disclosures to Health Plans. You may request in writing that we restrict disclosures of your medical information to a health plan for purposes of carrying out payment or healthcare operations if the disclosure is not required by law and the medical information pertains solely to a health care item or service for which you (or a person other than the health plan who is acting on your behalf) have paid us out of pocket and in full at the time of service. We must agree to a request that meets these requirements.

F. Changes to this Notice

We reserve the right to change this Section at any time. Changes will apply to medical information we already hold, as well as new information after the change occurs. We will post a copy of our current notice within our facilities and we will post it on our website at InspireAmind.net

G. Complaints and Requests

If you have questions about this notice or want to talk about a problem without filing a formal complaint, please contact Marcy Abramsky, LCSW at the following number: 716-791-7848.
If you believe your privacy has been violated, you may file a complaint with our organization or with the Secretary of the U.S. Department of Health and Human Services. Information about how to file a complaint with the Department of Health and Human Services may be found at the following website: http://www.hhs.gov/ocr/privacy/hipaa/complaints/index.html. You will not be penalized for filing a complaint.

CONTACT INFORMATION13.

If you have any questions about this Privacy Policy, the practices of this Site or under our Services, your dealings with this Site or our Services please contact by email at InspireAmind.net@protonmail.com or by calling 716-791-7848. Phone messages are necessary**As it is not always possible to answer at the time of your call, please leave a message with your name, phone or how you’d like me to get back to you and the subject/ urgency and your call will be returned as soon as possible. Thank you for your respect and understanding of this process.
If you are looking for an urgent return response in the form of email, please leave me both a voicemail with a phone number, and email request. Please understand that in some cases, we may need to speak so that I understand your request, and meet your need. Thank you.

All releases, consent and rights are provided to you within your portal as a client.

Thank you for your business and do not hesitate to ask any questions related to the above policies or services.

Marcy Abramsky, LCSW

716-791-7848

InspireAmind.net@protonmail.com

As per practice emergency policy: please call 911 or go to the nearest emergency room. No emergency messages or services are able to be managed by Marcy Abramsky, LCSW. As a Telemental Health service provider we urge you to utilize the nearest emergency resources and follow up after you are safe.

ADDED update 2022- present

AGREEMENT FOR SERVICE / INFORMED CONSENT

•This document contains important information about my professional services and business policies, including limits of confidentiality.

•Please read it carefully. When you sign this document, it will represent an agreement between us.

Therapist Background & Qualifications
•I have a Masters in Social Work and a Post Masters Certification in Educational Leadership. I have a License to practice as a Clinical Social Worker, Permanent School Social Worker and School District Leader Certifications in New York State. I  am also MST certified ( SC MST Institute ) as  a multi- systemic  therapist, and trained in cognitive behavioral therapy, Dialectical Behavioral Therapy, Brief Solution Focused Therapy, Neurolinguistics and  Mindfulness Based Therapy. I use an integrative approach which also offers tools from other modalities as well.

 •We will work to understand the role that our thoughts, beliefs, emotions, and behaviors have in our current struggles. In addition, a plan will be tailored to the specific ways that assist you in relieving your unwanted symptoms, gaining awareness, and learning skills and strategies that you can use to make changes, relieve suffering, and achieve your goals. My specialty is  working  primarily with  adolescents 12+ through adults, parents and senior caregivers. 

Risks and Benefits of Teletherapy…

 •Participating in therapy can result in a number of benefits to you, including a deeper understanding of yourself and your personal goals, improved relationships with others, and resolution of the specific concerns that are your motivation for beginning therapy.

 •However, therapy can have risks as well as benefits. While the primary goal of therapy may be to improve your well-being, it can also result in discomfort in order to improve your life. You may experience uncomfortable feelings such as sadness, guilt, anger, shame, frustration, loneliness, and helplessness.

Risks of Teletherapy / Electronic Communication

Risks

Teletherapy also has risks due to the general risks of technology. If ever there is a breach, you will be notified immediately.

What I do to protect your information:
•I am the only person with access to your information: other than with your consent( physicians, family, ins).

•Encrypted end to end email system. Portal messaging, and paperwork upload system and more. There is no video taping of sessions or anyone else in or near the office.

•My practice management program has HIPAA secure protection and bank secure technology for STRIPE to protect any payment information. I do not have access to your payment information.

 •In addition, I use a secure VPN which is my own internet line that is protected for our video / calls for your privacy and make a plan *** in case of disruption in service I will call you back. If we cannot reconnect within 10 min… I will reschedule our session to give you our time.

 •My office has a generator to account for outages. I have a BAA ( Business Associates Agreement with every company I work with from my email to my website provider. Nothing can be 100% safe. However, I have taken many precautions to mitigate risks in order to protect your information.

The BENEFITS of TELETHERAPYAre:

•convenience, less stress, no transportation needs, and less privacy concerns with being seen in offices.

 •If you choose to not use insurance or I do not take your insurance, outside companies are not provided with information about diagnosis or therapy sessions.

 •If you do, that information still remains confidential, and the companies I will be contracting with are Cigna Aetna, United Healthcare,BCBS, Empire and more! 

Records and Record Keeping
•To maintain best practice in my profession, I am required to keep keep treatment records. You are entitled to receive a prepared summary of your records if you’d like after a written signed request, within 15 business days of your request or quoted date.

Confidentiality

• The information disclosed by you in therapy is generally confidential and will not be released to others without your written consent.

*There are a few exceptions

( see below)

*Exceptions to confidentiality, include:

• If there is reason to believe a child, elderly person, or dependent adult is or has been abused.
• If you threaten to commit serious bodily harm to yourself or another person.
• If I am presented with a subpoena / court order, signed by a judge.

• In any of the above circumstances, I will only reveal the minimum information that is asked to satisfy the request. I will do my best ( when possible) to inform you of the information being shared and to whom I am sharing it with, before I do so.

Minors and Confidentiality

• If you are a minor, under the age of 18, your parents may be legally entitled to some information about your therapy. I will discuss with you and your parents what information is appropriate for them to receive and which issues are more appropriately kept confidential.

• Also see new No Surprise Fee Act 2022 link on menu on website

Fee and Fee Arrangements.

A standard session is 45-55 minutes and the standard fee is dependent upon your service. I will write your fee in, or speak with you, and send it to you in writing. Sessions longer than 60-minutes are charged for the additional time. If I need to adjust my fees in the future, you will be notified of any fee adjustment in advance. Sliding scale fees are available on a limited basis. All fees are due at the time of service.

• If for some reason you find that you are unable to continue paying for your therapy, please let me know. I would be happy to help you to consider any options that may be available to you at that time.

Insurance.

Currently,

• I am *waiting to be credentialed, any day as a provider with a billing company Headway who sets my fees for insurance. I have agreed to those fees. I am not a contracted provider with any additional insurance companies at this time.

• All insurance companies require a clinical diagnosis. Some may require additional information such as treatment plans or treatment summaries. In these instances I will disclose the minimum amount of information required for the requested purpose. You should also be aware that you are responsible for verifying and understanding the limits of your insurance coverage, and that you are responsible for any and all fees not reimbursed by your insurance company. Please let me know if you have any questions or concerns.

Cancellation 

• Standard policy for most therapists, myself included, is a 24-hour cancellation policy. If you do not show up for your scheduled therapy appointment, and have not notified me at least 24- hours in advance, payment will be required for half the cost of the session.
• Cancellations must be made through the link / portal app, email and or phone / text 716-971-7848 (24)hours prior to your appointment. You may share if you’d like to reschedule & a good time as well.

• A total of four missed appointments without prior notification may lead to full reimbursement and more, ending the therapy relationship.

Therapist Availability and Emergencies.

• I will make every effort to return calls within 24 hours (or by the next business day), but cannot guarantee your call will be returned immediately.
• I am not able to provide 24-hour crisis services. If you are feeling unsafe, or require immediate medical or psychiatric assistance, please call your physician, 911, or go to your nearest emergency local emergency room.
• In addition, if you are seeking resources, a number of resources are listed on the menu at the bottom of my website InspireAmind.net.

• As I will return your communication when it is possible I request that you do not use “emergency” calls for regular communication to discuss therapeutic content. We will get an earlier session set up. I will do my best with requests for emergency assistance – but again, please note that I do not provide emergency, 24 hour care or prescribe any type of medication.

Social Media and Telecommunication. •As the confidentiality of your information is of the upmost importance, I do not accept friend or contact requests from private practice clients on any social networking site (Facebook, etc). I believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy.

• It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up when we meet and we can talk more about it.

• I also suggest not posting about your appointments .. sometimes “in the moment” we may not realize we share information we don’t want out there later.

Termination of Therapy

• Ending relationships can be challenging. That is why it’s crucial to have a termination process in order to achieve some closure. The appropriate length of the termination depends on the length and intensity of the time working together ( treatment).
• I may terminate treatment, after appropriate discussion with you, if I determine that the psychotherapy is not being effectively used or if there are significant issues with nonpayment, non attendance etc.
• I will not terminate the therapeutic relationship without first discussing and exploring the reasons and purpose of terminating.
• You also have the right to terminate therapy at your discretion. If therapy is ended for any reason or you request another therapist, I will provide you with a list of qualified therapists, or a referral source. You may also choose someone on your own.
• Should you fail to schedule an appointment for four consecutive weeks, unless other arrangements have been made in advance, for legal and ethical reasons, I must consider the professional relationship discontinued.

 💡on a bright note … if you understand& agree… let’s get started-

Thank you for choosing my practice and look forward to working with you. Should you have any questions / let me know.

Inspiring One Mind At A Time!

 Please sign on the next page after you have read & agree

Consent for Teletherapy

I,______________________________(Name )                          (Birth Date) 

have read and understood the above and would like to participate in services via virtual tele-practice with Marcy Abramsky, LCSW in therapy.                  

                                                                                                                                        By signing this agreement, I acknowledge that I understand that Marcy Abramsky, LCSW, respects my confidentiality, with exceptions ( as mentioned above).

I understand the risks and benefits of Teletherapy and willingly giving my full consent. This consent will be valid throughout the duration of counseling sessions. I know that I may choose to revoke this any time in writing with an email notifying the office and a signed letter to revoke consent at any point, via mailing address

Thank you for reading the above.

Your signature indicates that you have read this agreement for services carefully and understand its contents and agree.

_______________________________

Name of Client: Print

 ___________________________

Signature of Client

 ______________________

Date of Signature

 Thank you M. Abramsky, LCSW

*Please upload this back into your patient portal!