|
Registration for e-Consultation or e-Sessions -- Please note that PsychOptions no longer Provides Consultation or Therapy Services |
|
Welcome to PsychOptions™ Registration!!! You have taken an important and positive step toward helping yourself! Our goal is to help and support you and to do so professionally and ethically. Therefore it is important that we understand and agree to the "ground rules" to avoid any misunderstanding about what PsychOptions™ can and cannot do as a service. Before you register you need to read and agree to the conditions and agreement that follows. Without your agreement to the following terms, you will not be able to proceed with the services offered by PsychOptions™. If you agree with the following Terms of Agreement just click " I Agree" button below. Through PsychOptions™, you can obtain support, information, guidance, and work on some specific issues. Venting your feelings may be therapeutic and may also provide clues as to what needs to bemore specifically addressed and sorted out. Following is an agreement between us that needs to be made and accepted for us to work together, especially if you are to decide upon on-going sessions. In this way you'll be able to understand the professional and ethical standards of PsychOptions™ and that you receive the best possible service that you need and deserve. |
|
Terms of AgreementI have read, understand, and I agree to the following: |
|
| 1. I am 18 years of age or older. | 6. I am not currently suicidal or violent or planning suicide or planning to harm anyone. If suicidal, I realize that this form of therapy is inappropriate and I will seek immediate help for myself (see If You're Suicidal). If I should become suicidal or violent, while receiving services from PsychOptions™, I will immediately inform PsychOptions™ of the change in my status and agree to seek immediate and appropriate help in my local area, through a crisis center or by calling 911. |
| 2. All e-consultations and services will be deemed as taking place in the state of Pennsylvania, where PsychOptions™ resides. I understand that PsychOptions™ does not and will not diagnose or treat any mental or psychological conditions or disorders and will not and does not take the place of traditional therapy/psychotherapy. I am not currently in therapy, nor have I been diagnosed with a serious mental illness. I am not currently under the care of a mental health practitioner or a psychiatrist. I also understand that PsychOptions™ does not ever diagnose or treat any physical conditions or medical disorders whatsoever. | |
| 3. Every effort will be made to keep our communications confidential, but unsecured e-mail cannot be completely confidential or guaranteed confidential. No information will be provided to a third party or any family members or relatives. I realize that the US Courts have the right to subpoena information from PsychOptions™ should our conversations somehow relate to a court case, in which I may be involved. | 7. I also realize that due to the limitations of on-line and/or telephone services, I need to be honest, clear, and open with PsychOptions™ and provide key and important information. |
| 8. PsychOptions™ will make every effort to behave respectfully and with sensitivity during our sessions, but I understand that the same kind of service, as found in face-to-face therapy, cannot be provided. | |
| 4. If at any time, PsychOptions™, or any of its representatives should determine that I am a danger to myself or others I understand that PsychOptions™ is morally and legally required to report this to the authorities. I also understand that PsychOptions™ is also required to report to the appropriate authorities any abuse of children or elders, or if they are in danger of possible abuse or harm. | 9. There is no commitment on either party to continue with any services or communications, and services can end at any time by either party, with no further obligation to the other. PsychOptions™ will return any unused fees and gladly suggest other resources for help. I do agree to pay for any and all services provided. |
| 5. I accept full responsibility for my own psychological and medical welfare and am responsible for seeking my own psychiatric and/or medical care and treatments. | 10. I understand that there are obvious limitations to these on-line/telephone services and PsychOptions™ cannot be held responsible for information not provided by me, or insufficient information, and therefor I cannot expect the kind of or level of support or service that is received in traditional services such as face-to-face therapy or psychotherapy. |
| I understand and accept the above conditions and agree to hold PsychOptions™ or any of its representatives harmless of any and all liability arising from these communications or services. ( If you agree with the above terms click "I Agree" below.) | |
Copyright © 2000, PsychOptions™. All rights reserved. PO Box 49, Narberth, PA 19072