Client Rights
As a Client of Inner Canvas Counseling, you have a right to:
Be treated with respect, courtesy and non-discriminatory treatment and be shown respect for your beliefs, social views and cultural backgrounds.
Be informed of the counselor’s assessment of the problem and ways it can be dealt with.
Share in goal setting and discussing treatment/services and the number of sessions expected with the counselor.
Expect confidential handling of records in accordance with the law and professional standards.
Receive information about the Agency’s fee schedule.
Request your records. You may be charged for the cost of duplicating the case file material.
Be represented, through clinical documentation or by the provider, in court proceedings. Please see Financial Information Form regarding the applicable fees.
Know the reasons for transfers, referrals and discontinued sessions. Examples of this would include threats made toward the counselor or Agency, missing two or more appointments without 24-hour notice, etc.
Know that the counselor must: report suspected abuse or neglect of minors/vulnerable adults; report imminent danger to you or others; report information in required court proceedings; report information required by your insurance company or to a collection agency for delinquent accounts; defend claims brought by you against the counselor.
Be informed of procedures for filing a complaint if unsatisfied with services received.
Know that information can be provided in a way that meets your communication, learning and/or literacy needs.
Have artwork anonymously utilized for teaching, advertising, publication, and training and know that artwork left with the therapist after termination of services (including no contact after 3 months) will be destroyed.
Be provided with resources for accessing emergency/crisis support outside of scheduled counseling sessions.
Be provided with email information for asking simple questions, asking about rescheduling times, or for providing a quick update. Email and text message may also be used for appointment reminders and receipt of payment, if requested.
Client Responsibilities
As a Client of Inner Canvas Counseling, you are responsible for:
Taking an active part in counseling and service by sharing ideas and asking questions and by providing accurate and complete information.
Being open to looking at problems in new ways and trying new behaviors.
Telling the counselor if you cannot keep an appointment. You may be charged the cancellation fee if you do not give the counselor 24 hours advanced notice. An EAP or insurance company will NOT pay for this fee.
Paying any fees that have been agreed upon. Fees for service at Inner Canvas Counseling are listed in the Financial Information Form. Fees may be reduced by utilizing EAP or insurance coverage. An income-based, sliding fee scale is not offered at this time. Co-pays are due at time of session and credit card information can be stored for such. Clients are responsible for knowing insurance information and reporting on coverage. Retroactive billing for services will not occur if cash-pay is agreed upon or if changed insurance information is not provided by time of billing. Inner Canvas Counseling uses an outside biller, Magelky Consulting, and also Red River Collections.
Respecting the privacy of other people served by the agency.
Following a service plan. You must respect the agency’s right to discontinue services if you do not follow the service plan.
Inner Canvas Counseling reserves the right to deny further services if you do not fulfill the above responsibilities or if the service’s funding is cut.
Opting in or out regarding email or text message communication as well as refraining from cell phone use or recordings during sessions.
By signing below, I hereby acknowledge that I have received and been given an opportunity to read a copy of Inner Canvas Counseling’s Client Rights & Responsibilities, attached.