I do not collaborate or communicate with the police regarding my therapy practice and I don’t communicate with ICE at all unless I am legally required to do so, and I don’t know any therapist that would. Doing do would be a violation of HIPAA, a law that protect individuals’ health information.

I do not have a physical office outside of my home. If ICE comes to my house, I would not open the door unless they show me a judicial warrant signed by a judge through the window in my front door. If this occurs, I would not speak to them without an attorney present. I would not share any information about any client, as this would be a violation of HIPAA.

The only times any of a client’s information would be shared in a legal setting is if the client has provided written consent or if I receive a legitimate subpoena accompanied by a court order signed by a judge. In this situation I may be required to provide part or all of your record. I only include in your record what is clinically relevant. This means that my notes focus on your symptoms and how we are addressing them, not on the broader context of those symptoms.

If you or someone you know needs support with immigration concerns in Illinois, visit ICIRR’s website to see their resources including a Know Your Rights pamphlet and a hotline number.

I only include in the record what is clinically relevant. This means that I focus on documenting your presenting symptoms and how we are addressing them, not the broader context. Some examples of phrases I might use in notes are:

• “Client reported feeling stress regarding medical care.”

• “Client reported feelings of frustration due to family conflict.”

• “Client discussed feelings of confusion regarding their self-concept.”

In all notes I use the word “Client” in place of your name and use “they/them/their” pronouns for all client when needed for readability. I know that using they/them/their pronouns in notes might feel invalidating for some who do not use these pronouns, but this is done to protect your confidentiality.

I currently have availability on Mondays through Wednesday evenings.

The fee for a 53-minute session is $150.

If you do not have BCBS PPO, then you are responsible for the full $150 fee at the time of the session. However, once a month I will provide a superbill (a document which lists what services you have paid for and how much you have paid) that you can submit to your insurance for reimbursement if they provide out of network benefits. I recommend that you call your insurance to ask if you have out of network benefits for mental healthcare before starting therapy.

Appointments must be cancelled or rescheduled 24 hours or more before the scheduled appointment time. When appointments are cancelled less than 24 hours before the appointment time, the full cost of the session ($150) will be charged to the client unless in the case of illness or emergency. This fee cannot be billed to insurance.

Most of the time, everything that occurs in session and all of your records are completely confidential unless you provide written consent for me to provide information about your treatment to someone else. However, there are exceptions which include:

• If you tell me you are planning and intend to attempt suicide or to seriously injure yourself

• If you tell me you plan to bodily harm another person

• If I have reason to suspect that you are a perpetrator or witness to the neglect or abuse of a minor or vulnerable adult

• If there is an emergency in which I have to contact your emergency contact or medical personnel on your behalf

• If I receive a legitimate subpoena accompanied by a court order signed by a judge

• When I bill your insurance, they can see your identifying information and your diagnosis.

• If your insurance company requests your records to verify the medical necessity of treatment

I want to avoid having to report anything against your will. If it ever seems like any of the above situations might become possible, we will collaborate to develop a care plan that centers your needs and minimizes the state’s involvement in your treatment.

I might consult on your case with other providers to ensure I am providing you with the best care possible. However, I would never use personally identifying information when doing so unless you have provided written consent for me to do so.

I store all client records in Simple Practice, a HIPAA-compliant electronic health records system. This system is password protected and I am the only person who has access. My computer is also password protected.

• Email: I use Google Workspace with encryption from Paubox, which is HIPAA compliant. My computer is password protected and my email account has 2-factor authentification.

• Telephone and fax: I use RingRX for phone calls, voicemails, and faxes. RingRX is HIPAA compliant. My phone has a passcode that must be entered to open.

• Texting: Texting is not a HIPAA-compliant form of communication. However, there is a HIPAA-compliant way to message through Simple Practice that is accessible in the client portal on the desktop website or on the Simple Practice Client Portal app.

If we see each other outside of session, I will not initiate contact with you. This is mainly to protect your confidentiality, but also because I know you might not want to talk to your therapist outside of sessions. You are free to initiate contact with me, in which case we can talk briefly.

No, I will not add any current or former clients as friends or contacts on social media accounts.