Politiques et Déclarations Supplémentaires

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. If you have any questions about this notice, please contact us at the address below.

We are required by law to maintain the privacy of protected health information, to provide you with notice of our legal duties and privacy practices with respect to protected health information, and to notify affected individuals following a breach of unsecured protected health information. We must follow the privacy practices that are described in this notice while it is in effect.

Uses and Disclosures of Your Health Information

We may use and disclose your health information for the following purposes:

• Payment: To bill and collect payment for services rendered.
• Treatment: To provide, coordinate, or manage your health care and related services.
• Health Care Operations: For administrative, financial, legal, and quality improvement activities.
• Appointment Reminders: To contact you with reminders about appointments or information about treatment alternatives.
• Research: Under certain conditions, for approved medical research.
• Law Enforcement: When required by law or court order.
• Public Health Activities: To report disease, injury, or vital statistics to public health authorities.
• Organ and Tissue Procurement: To organ procurement organizations for donation purposes.
• Correctional Institutions: If you are an inmate, to the institution as necessary for your health and the safety of others.
• Business Associates: To contractors who perform services on our behalf, under written agreements to protect your information.

Specially Protected Categories of Health Information

Certain categories of health information receive extra protection under state or federal law, including: Alcohol and Substance Abuse Records, Biometric Information, Child and Adult Abuse Records, Communicable Disease Information, Genetic Information, HIV/AIDS Status, Mental Health Records, Minors' Records, Prescription Information, Reproductive Health Information, and Sexually Transmitted Disease Information.

Your Rights Regarding Your Health Information

• Request restrictions on certain uses and disclosures.
• Receive confidential communications of your health information.
• Inspect and copy your health information.
• Request amendments to your health information.
• Receive an accounting of certain disclosures.
• Receive a paper copy of this notice.

Contact Information

Introduction

Welcome to ReachLink. Before beginning services, please read this Informed Consent carefully. By engaging with our services, you agree to the terms described below.

The Therapeutic Process

Psychotherapy is a process in which a therapist and client work together to address mental health concerns. The process may involve discussing past experiences, current challenges, and developing coping strategies. While therapy can be highly effective, results vary by individual and are not guaranteed.

Confidentiality

Your privacy is important to us. Information shared during sessions is confidential. However, there are legal and ethical exceptions to confidentiality:

• If you present a serious risk of harm to yourself or others.
• If there is suspected abuse or neglect of a child, elder, or dependent adult.
• If a court order requires disclosure.
• If you are involved in a legal proceeding and your mental health is at issue.

Telehealth Consultation

Services may be provided via telehealth, including video, phone, or secure messaging platforms. Telehealth has benefits (convenience, accessibility) and limitations (technology issues, reduced non-verbal communication). You have the right to withdraw consent for telehealth at any time and request in-person services where available.

Video Recording

Sessions are not recorded without your explicit written consent. If recording is desired for any reason, a separate authorization form will be provided.

By providing your credit card information through the ReachLink portal, you authorize ReachLink to charge the card on file for all services booked through the platform. Your card will be charged at the time of booking.

Authorization Details

• You authorize ReachLink to charge your card for all portal-booked services.
• Charges will occur at the time of booking confirmation.
• Your card information is stored securely and used only for ReachLink services.
• You will receive a receipt for each transaction via email.

Cancellation Policy

To update your payment method or dispute a charge, please contact our Care Coordination team at 1-833-732-2489 or hello@reachlink.com.

Colorado — C.R.S. § 12-245-216 Disclosure

Pursuant to Colorado Revised Statutes § 12-245-216, the following information is provided to clients receiving mental health services in the state of Colorado.

Licensed Levels of Practice in Colorado

• LCSW — Licensed Clinical Social Worker
• LSW — Licensed Social Worker
• LMFT — Licensed Marriage and Family Therapist
• LPC — Licensed Professional Counselor
• Psychologist — Licensed Psychologist
• CAT — Certified Addiction Technician
• CAS — Certified Addiction Specialist
• LAC — Licensed Addiction Counselor
• Unlicensed Psychotherapist — Registered with the state

Governing Board

Client Rights

• The right to be informed about the therapy methods and fees charged.
• The right to seek a second opinion or terminate treatment at any time.
• Sexual intimacy between a therapist and client is never appropriate.
• Confidentiality of all therapist-client communications is protected by law.
• Client records shall not be kept beyond 7 years from the date of termination.