Informed Consent

INFORMED CONSENT

BENEFITS/RISKS
It is important that you know what to expect from telephone or online sessions. We therefore, ask you to read, sign and mail us a copy of this informed consent as you begin your coaching.

My Services can be beneficial to most people who become involved in the process, however this cannot be guaranteed. Your commitment to your own growth will largely determine the benefits you will gain. There may be times we will need to refuse to treat situations we believe can not be handled appropriately, using the telephone or the Internet.

CONFIDENTIALITY
All information communicated between Dr.Stonbely and client will be held in confidence. No information will be released unless you make such a request in writing. However, in order to keep you and/or others safe, there is no confidentiality, should you disclose incidents of child or elder abuse, or threats of bodily harm to yourself or another.

In legal cases, privileges may not stand. Dr, Stonbely charges hourly rate of $300.00 portal to portal travel time to and from any legal appearance plus 300.00 per hour of testimony. Any cancellation must be made 48 hours to travel or full payment is charged.

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RECORD KEEPING 
I will make brief, confidential notes of your sessions. My  policy is to place these records  and store them outside of our computers, to prevent access by unauthorized persons.

CANCELLATION POLICY
Notify us either by telephone or email at least 24 hours before your appointment and you will not be charged. You may either request a reschedule or cancel your session. If your notification is less than 24 hours of your scheduled session, you will forfeit your payment..

I have read and understand 1) , 2) the limits of confidentiality and, 3) cancellation policies. I am 18 years or older