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Privacy & Policy

Confidentiality & Privacy policy

The law protects the relationship between a client and a psychotherapist, and information cannot be disclosed without written permission.

Exceptions include:

  • Suspected child abuse or dependant adult or elder abuse, for which I am required by law to report this to the appropriate authorities immediately.

  • If a client is threatening serious bodily harm to another person/s, I must notify the police and inform the intended victim.

  • If a client intends to harm himself or herself, I will make every effort to enlist their cooperation in ensuring their safety. If they do not cooperate, I will take further measures without their permission that are provided to me by law in order to ensure their safety.

Payment

  • Co-pays, allowables, coinsurances, and out-of-pocket rates are to be paid at the time of your appointment, per your insurance contract.

  • Benefits for mental health coverage do vary from one carrier to another; contact your insurance provider and/or the office if you have any questions or concerns regarding your mental health benefits or authorizations.

  • The office accepts cash, credit/debit cards, and checks for payment.

  • A credit/debit card is required to be on file. If cash or a check is not given at the time of your appointment, the card on file will be processed for payment.

  • If a check given for payment does not process, a $35.00 NSF Fee will be charged in addition to the balance previously owed. In addition, checks will no longer be accepted as a form of payment.

***Please note that a 4% fee will be charged when using a credit/debit card for payments. To avoid this fee, please use cash or checks as your payment method***

Appointment Policy

  • Office visits are by appointment only and vary according to each provider's schedule and a patient's need.

  • If you need to cancel and/or reschedule your appointment, we ask that you do so MORE THAN 24-hours in advance of your scheduled appointment time. 

  • For established clients, if you cancel and/or reschedule less than 24 hours in advance or do not show up for your appointment, you will be charged a $50.00 No Show/Late Cancellation Fee.

  • For new clients/initial evaluations, the same 24-hour policy applies for cancelling/rescheduling appointments, however, if you cancel less than 24-hours in advance or do not show up for your appointment, rescheduling will be unavailable due to the provider's limited scheduling availability.

  • Adults over the age of 18 must schedule their own appointments; If for any reason they are unable to schedule on their own, please contact the office regarding scheduling.

Prescription Refills

  • All prescription refill requests must be called in a minimum of 7 business days before your medication runs out to ensure Dr. Bonin is able to get to the request in a timely manner.

Fees

Forms:

  • There is a $25.00 fee per every half hour required for your provider to complete any requested forms or paperwork.

Records:

  • Records requested by other physicians or health professionals rendering active treatment are free of charge.

  • If requested by the individual client, records are printed at the costs listed below:​

Pages 1-25

Pages 26-300

Pages 301+

$1.00 per page

$0.50 per page

$0.25 per page

Processing Fee 

$25.00 per half hour

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