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Under federal law, health care providers must give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services. All sessions are $125.
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Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.I am committed to maintaining the privacy and security of your protected health information (PHI). I am required by law to provide you with this notice regarding this policies.
How I May Use or Disclose Your Health Information:
Treatment: I may use PHI to provide and coordinate your healthcare.
Payment: I may use/disclose PHI to bill and collect payment for services.
Operations: I may use PHI for quality assessment, training, and administration.
Your Rights:
You have the right to access, inspect, and copy your health records, request amendments, and request restrictions on certain uses.Complaints:
If you believe your privacy rights have been violated, you may submit a complaint the Ohio Board of Counselor and Social Worker Board.Additional Information:
https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/model-notices-privacy-practices/index.html -
Jordan Redman Ohio License (LPC): C.2406127
Liz Mannon (Supervisor) Ohio License (LPCC-S): E.2001746-SUPV
Client’s may contact the Ohio Board using the following information:
Counselor Social Worker & Marriage and Family Therapist Board
77 S High St 24th Floor, Room 2468, Columbus, OH 43215
e-mail: cswmft.info@cswb.ohio.gov phone: (614) 466-0912
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I am not a 24-hour crisis provider. In the event of a mental health emergency, please contact 988 or go to the nearest emergency room.