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Terms and Policy

Notice of Privacy Practices (HIPAA)
Notice of Privacy Practices (HIPAA)
Seeking Shalom (8/15/2015)

Your Information. Your Rights. Our Responsibilities.
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.

SUMMARY –
Your Rights
You have the right to:
• Get a copy of your paper or electronic medical record
• Correct your paper or electronic medical record
• Request confidential communication
• Ask us to limit the information we share
• Get a list of those with whom we’ve shared your information
• Get a copy of this privacy notice
• Choose someone to act for you
• File a complaint if you believe your privacy rights have been violated
Your Choices
You have some choices in the way that we use and share information as we:
• Tell family and friends about your condition
• Provide disaster relief
• Provide mental health care
• Market our services and sell your information
• Raise funds
Our Uses and Disclosures
We may use and share your information as we:
• Treat you
• Run our organization
• Bill for your services
• Help with public health and safety issues
• Do research
• Comply with the law
• Respond to organ and tissue donation requests
• Work with a medical examiner or funeral director
• Address workers’ compensation, law enforcement, and other government requests
• Respond to lawsuits and legal actions
Your Rights
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
• You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
• We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
• We may require you to meet with a provider to review with you the information being released and if this is required you would be responsible for the full fee for that session.
Ask us to correct your medical record
• You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
• We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications
• You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. You may also ask to restrict how we use particular contact methods.
• We will say “yes” to all reasonable requests.
• In the absence of such a request, you consent for us to use to contact you using any method that you have provided, including leaving messages at any of your phones, contacting emergency contacts, sending text messages and using non-secure email addresses.
• Should you contact us using regular email (not using the secure messaging system we have provided), you are providing your consent for us to respond by regular non-secure email.
• In contacting us by phone, or having us contact you by phone, you understand that phone calls to us may be forwarded to a staff person’s cell phone and/or answered by a third party answering service. As such, you understand our phone systems may not meet all privacy standards and waive need for that level of phone security.
Ask us to limit what we use or share
• You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care or if it would interfere with any legal or ethical obligation that we have.
• If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information. If you are paying for a service or health care item out-of-pocket in full, you are agreeing to be responsible for the full price you have paid even if later it is determined that your health insurer would have negotiated a lower price or rate with us for which you would have been or later become eligible.
Get a list of those with whom we’ve shared information
• You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
• We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy notice
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly. This notice may be downloaded from our website and from within the client portal your clinician may make available for you to use.
Choose someone to act for you
• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated
• You can complain if you feel we have violated your rights by contacting us using the information that may be found in the Client Information and Office Policies document.
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
• We will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
• Share information with your family, close friends, or others involved in your care
• Share information in a disaster relief situation

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases we never share your information unless you give us written permission:
• Marketing purposes
• Sale of your information
• Most sharing of psychotherapy notes
In the case of fundraising:
• We may contact you for fundraising efforts, but you can tell us not to contact you again.
Our Uses and Disclosures
How do we typically use or share your health information?
We typically use or share your health information in the following ways. In some cases, we utilize third parties to conduct this use or sharing, for example we use an outside company in some cases to send you a reminder notification of your appointment.
Treat you
We can use your health information and share it with other professionals who are treating you or who are otherwise involved in your care.
Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization
We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Example: We use health information about you to manage your treatment and services.

Bill for your services
We can use and share your health information to bill and get payment from health plans or other entities.

Example: We give information about you to your health insurance plan so it will pay for your services.

How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Help with public health and safety issues
We can share health information about you for certain situations such as:
• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety
Do research
We can use or share your information for health research.
Comply with the law
We will share information about you if local, state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests
We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:
• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services
Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena. We may also share your health information to respond to lawsuits, legal actions or license defense cases in which we or one of our clinicians are named as a party and which relate to your care.

Our Responsibilities
• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. We will provide you with a form to authorize release of information. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.

Other Terms for this Notice
Applicability of this Notice and Contact Information
• This notice applies to Seeking Shalom including the following entities: Seeking Shalom Marriage and Family Therapy, P.C. (New York), Seeking Shalom Mental Health Counseling, P.C. (New York), Seeking Shalom New York (New York), and Seeking Shalom of Indiana, Ltd. (Indiana). It shall also apply to their clinicians and staff, including the Rev. Christopher L. Smith, LCAC, LMHC, LMFT.
• The Effective Date of this Notice is August 15, 2015.
• The privacy official for our organization is the clinical director.
Particular Situations
• Seeking Shalom is deeply committed to protecting the privacy and confidentiality of our clients. It should be noted that there are practices allowed for in this notice that we rarely or never utilize, including some that are not particularly applicable for our type of services.
• Psychotherapy notes have more protection – most notably from third-party payers. These are considered the sole property and privilege of the clinician and may not be shared with anyone (including the client) under any circumstance absent sufficient compulsion by a court. These notes are kept distinct from other items in the chart including the progress notes. They are not provided when a copy of the chart is requested.
• In cases where a couple or family is engaging in counseling or therapy together, even if one person is the client, we will not release health information from the joint sessions based on the request and authorization of just one of the parties, even if they are the formally identified client.
• In the case of counseling or therapy involving multiple parties, we reserve the right to not release information to a third party even when each person has provided written authorization.

• Some clinicians at Seeking Shalom are members of the clergy. This alone does not extend clergy confidentiality to what is discussed during any service provided by that clinician. It may be possible to have clergy confidentiality cover some specific communications, as allowed by local and federal law; however, this will require both clinician and client to know this is occurring.
Particulars for a Teaching Practice and of Recordings
• While it is common practice, we want to let you know that your identity may be revealed on surveillance recordings that we or other parties (especially those operating spaces in which we provide services) make, use or disclose.
• When a clinician makes a recording (audio, photographic, or video) for educational purposes (self monitoring, supervision or training), the recording will not become a part of your file and will be destroyed as soon as its purpose is completed, usually within a month. Your refusal to be recorded may impact on the quality of care that you receive and could result in our inability to provide you with services (especially in cases where a clinician is not independently licensed).
• As Seeking Shalom is a teaching practice, some of our use of your health information may include education and training uses, although your privacy and confidentiality is always protected as much as possible during these uses.
• As a clinician develops, either as a professional or on a particular technique, the clinician may work with clinical supervisor(s), both within and external to Seeking Shalom. Parts of this process may use your health information and may also involve other clinicians and student clinicians.
• As a teaching practice, some of our clinicians may be enrolled in graduate training programs. In these cases, your health information may be shared within the program at their institution.
• You have the right to ask about how the clinicians involved in your treatment are connected to the teaching side of the practice. If because of your clinician’s level of training the state requires a clinical supervisor at Seeking Shalom, you have the right to know this, you will be consider a client of the supervisor, and have the right to know how to contact the supervisor.
Referral Sources including Mandated Referrals
• You have the right to ask us to not contact the person who referred you to us. If the referral source is not another healthcare provider we would want to coordinate care with, our use of your information would be limited to express our appreciation for their referral and let the referral source know that you have followed through, unless you ask us not to do so.
• Unless a reason to use or share your health information has already been discussed in this notice, we will not provide ongoing reports to another entity that has made a mandated referral (such as a court order for a type of counseling) without a written release of information for that communication. If you do not provide us with such a release, then we will not be able to verify to that entity whether or not you are complying.
Miscellaneous Provisions
• When information is released to other parties, we reserve the right to charge a reasonable fee not only for our costs in copying and mailing your requested information but also for clinicians to complete summaries of your file and other reports.
• These rights, responsibilities and uses will be altered to comply with all local and state laws.
• Some other information related to privacy may be found in the companion document “Client Information and Office Practices”. This document also contains our contact information.
( Type Full Name )
( Full Name )
Client Information and Office Practices
Client Information and Office Practices
Seeking Shalom (8/15/2015)

Info on Our Practice. Info on Your Treatment.
This document describes important information about our practice and that you should know about what is involved in getting treatment. It should be read in conjunction with our Privacy Policies that also contain important information. Please review it carefully.
SUMMARY –
Offices and Contacts
• Where our offices are located and how different offices are used
• Other ways of contacting us (especially by phone or email) and response times you can expect
• How we do and do not use social media
Appointments
• What the timing of appointments usually look like
• How to schedule appointments and deal with clinician* absences
• Processes for lateness and cancellations
Financial Matters
• Issues to be aware of regarding our fees, including what fees you can expect
• Insurance matters as well as factors relating to other payments
Clinical Matters
• How you are assigned a clinician and how this may be able to be changed
• How confidentiality and emergencies are handled
• Disclosures about the process of therapy*
• Description of the flow of treatment and what termination looks like
Teaching Practice Processes
• How our clinicians all engage in continuous quality improvement
• Issues related to supervision and some opportunities this provides for you
• Considerations around pre-licensed clinicians
Client Rights and Responsibilities
• The rights and responsibilities that every client at Seeking Shalom have
Applicability of this Information & Changes to these Practices
• A description of the entities following these practices and their relationships
• How these practices may be changed and the effect of any such changes

* throughout this document therapy and counseling are used interchangeably and clinician includes therapist and counselor

Offices and Contacts
Seeking Shalom maintains a number of offices:
• Midtown
o 124 East 40th Street, Suite 404, New York, NY 10016
o To get access to the waiting room, use code 134A on the suite’s main door.
• West Bronx
o 2345 University Ave, Bronx, NY 10468
o Access is via the Parish Office entrance, which is closed for lunch and supper.
• Northeast Bronx (pending)
o 971 East 227th Street, Bronx, NY 10466
• Group Locations
o These will be announced when the group is announced.
• Indiana
o Program locations will be announced to those attending a particular program.
• “Home Visit”
o In some cases, services are delivered by distant technology (such as video, telephone, chat) on platforms that provide appropriate settings for clinical services.

• Your clinician will practice in one or more of these locations. If your clinician practices in more than one of these locations, your clinician will let you know whether or not you can see them at more than one location.
• Clinicians may have set schedules at different offices but this does not mean that they will always be there during those hours or that they will be free at those times. Clients should not attempt to “drop in” at a particular office location as there may not be anyone available to see them.

• Our administrative address, which should be used for all correspondence is
o P.O. Box 685, Harrison, NY 10528
o We do not intend to receive mail at any of the other addresses.

You may get in touch with us by telephone (with the understanding of the type of telephone system we use, as outlined in our Privacy Policies). You will have available to you one or more of the following numbers:
• Main Office Number (212-655-9605): this number can be used for general purposes and may be answered in different locations, calls will be returned as quickly as possible but you may expect that a returned call may take up to four business days
• Business Line Number (646-513-2866): similar to the main office number except that it connects to our business office, primarily used for contacts with other businesses and not with clients, calls to this number are answered with lower priority than calls to the main office number
• Answering Service (646-513-2867): if your clinician is served by the answering service, this number provides a 24/7 contact method by which a message can get clinical attention within a few hours of your call and you can expect a more timely response, usually within one or two business days; some clinicians may also arrange to have this number be able to be used by their clients for assistance with symptom management and/or to manage appointments; in the event of a problem with the answering service, calls will generally be routed to a special voicemail box
• Direct Numbers for Particular Programs or Special Services: some programs or services (such as those in a particular language) may have their own phone number, calls made to these numbers are routed to staff associated with these particular programs or able to assist with this special service; these numbers will be published and available to those who might need to use them; calls will be returned as quickly as possible but may take up to a week
• Direct Numbers for Clinicians or Staff Members: clinicians and certain staff members have their own direct number through which clients can reach them; these numbers may be forwarded to the staff members in different locations and in different ways, calls will be returned as quickly as possible but you may expect that a returned call may take up to four business days or even a week if the person is part time; these numbers are published and you may ask your clinician or staff member if they have one
• Day of Appointment Number for Clinicians: these numbers are to be used for quick issues relating to an appointment occurring on the same day such as needing access to the building, forgotten details of the location of the appointment, running late to the session; ordinarily, these are the only phone calls that are answered by a clinician when the clinician is with a client, so understand that you are likely interrupting someone else’s session when you call this number so calls should not be frequent and will be brief; some clinicians use their direct number for this purpose in which case you are more likely to get voicemail than immediate assistance
• Text Messaging: generally clients are not able to reach clinicians or staff members by text message, however, we may reach out to you by text to provide you with updates and some clinicians use systems that provide you with a text reminder of your appointments, generally twenty-four hours in advance; if you do not want to receive these text messages, you may make that request through your clinician
• FAX (646-513-2860): the main number for Seeking Shalom to receive faxes
• Secure FAX (646-513-2859): a separate fax line through which Seeking Shalom can receive faxes securely, this is particularly appropriate when the content involves protected health information
• Personal Cell Phone Numbers of Clinicians or Staff Members: clients will not be given the personal cell phone number of their clinician, or other staff members; the above contact methods provide other ways to reach them and are what should be used
We have provided a number of ways of contacting us by phone but please understand that we are not always available to be able to talk to you between sessions. Also, please understand that your ability to reach a clinician or staff member will be affected by their schedule (which may be different than typical given that we operate on a seven day a week schedule and have hours ranging from the morning through the evening). After hours, you should generally not expect to reach a live person, with the possible exception of staff at the answering service.

You may get in touch with us by email (with the understanding that some types of email communication have privacy limitations). You will have available different ways of using email:
• Your clinician or staff person may have a direct email address that you can use that will be provided to you. If you chose to use this email address, be aware that email to and from it will be using commercial email channels and should not be considered secure. This includes the possibility of email carriers scanning the content of the email and/or third parties reviewing the content without disclosing that they are doing so.
• Clients may be provided a secure method of communicating by email (such as the secure messaging system in the client portal). These messages are encrypted and require the sender and receiver to both use passwords. When available, this will be the method that we will chose to send email to you unless you have contacted us first using email that is not secure.
• We have email addresses established for particular purposes (such as ClinicalDirector@SeekingShalom.org for the clinical director) that may utilize regular or secure email methodologies.
• The practice maintains several regular email addresses that can be used for general purposes including NewYork@SeekingShalom.org and Indiana@SeekingShalom.org.
• Other systems we use may also provide email notifications to you including:
o email notifications from the client portal for appointment reminders or announcements (these can be customized by you)
o requested receipts from credit card payments
Generally these notifications cannot be responded to.
• In the event that we contact you through an email list that we maintain of current or former clients, you have the right to ask us to remove you from that list and receive no further communication sent to that list. This will not restrict our right to use your email address to contact you individually about matters that relate to you.
Web Presence:
• Seeking Shalom maintains a web site at www.SeekingShalom.org. This website contains information that may be of interest to potential and current clients. We also use this website to provide information updates that clients are encouraged to regularly review.
• Seeking Shalom is also present on other sites including directories and sites offering information.
• Information that we offering on the web, as with other written documents, are general information and clients should not consider them to be specifically about them or applicable to their case without discussing these with their clinician or another qualified professional.
Patient Portal
Clients may be given access to a patient portal by their clinician. This is a password protected access to parts of the electronic health record maintained on the client. Additionally, it may provide a number of features that the client may find helpful such as:
• Online Calendar System: allows a client to make, change and cancel appointments (within certain time periods) as well as see the times of available appointments with their clinician
• Secure Messages: a secure email system that can be used between client and clinician
• Ability to Review Treatment Plans: when shared electronically by the clinician
• Forms: clinical forms that can be completed online to avoid he need to use paper
• Billing Information: copies of invoices and payment receipts, make online payments
• Settings Preferences: ability to change how the portal works, including notifications received
• Journal: an online journal, unlike the other parts does not have to be shared with the clinician
Clients with any questions about the client portal should speak with their clinician.

Involvement through social media:
• As social media has the possibility of blurring boundaries and to avoid the possible complications of dual relationships, Seeking Shalom has adopted a policy whereby our clinicians do not form associations with clients through social media, including any type of being linked or becoming friends. Such requests will ordinarily be declined if they are made.
• As part of our professional practice, Seeking Shalom does maintain a presence on a number of social media platforms. We would welcome clients to connect with our professional presence by liking or following our content.

Reviews of Our Work:
• We understand that there are third parties that collect reviews of the work of all sorts of service providers and that some of these even focus on people that provide the types of services we offer.
• Seeking Shalom and its clinicians never solicit your public review of our work. We believe that to do so would not be right given the type of relationship that we have with you. We are also concerned about the fact that you may not understand the full impact of something that you say in a review. We are also concerned that someone else who reads a review may feel concerned about how we might use their personal information from a confidentiality standpoint.
• We may at times ask for your feedback, because we understand that you can play an important role in helping us understand how we can serve you and others better and that you can provide insight into what we are doing well. Clinicians may also provide simple ways to provide ongoing feedback (such as a couple question session review form in the client portal).
• Your best review of our work is honest interaction with us and personal recommendations. We would only want you to make personal recommendations if you were comfortable and if you felt that the other person might benefit from the types of services we offer.

Appointments
Appointment Timing
• Generally, appointments are scheduled on the hour or on the half hour. If your clinician’s schedule is different, they will let you know.
• Our standard appointment block is an hour. The beginning of this time is spent between you and the clinician. The last 5-15 minutes (depending on the type of appointment) of the appointment is spent by the clinician alone for the clinician to write a progress note and take care of other matters they need to attend to before the next appointment block.
• Administrative matters (such as payment, scheduling appointments or other matters that need to be addressed) may be handled during the beginning or end of your time with the clinician
• When the situation warrants it, there are other time frames that may be possible, for example:
o someone who is also involved in group therapy may only need appointments based on a half hour block in order to have the opportunity to touch base on individual matters
o some clinicians in some programs may provide for a longer initial session
o a client coming more for assessment than treatment may require longer sessions
o in some cases, a couples or family session may be combined with an individual session with the combined session occupying a ninety minute block instead of a two hour block
• Generally, sessions will initially occur on a weekly basis. Depending on clinical need and practical considerations, the frequency of sessions may increase or decrease. Generally, while in active treatment clients should expect to have sessions no less frequently than monthly and no less frequently than quarterly if they are receiving therapeutic checkups. We may make your case inactive if you are coming less frequently than this.
• The frequency of appointments and any deviation from the standard appointment block will be discussed with clients by their clinician.

Appointment Scheduling
We believe that different clients have different scheduling needs and should be in control of their schedule, within the availability of their clinician. To this effect, please consider:
• Clinicians may practice with fixed schedules relative to particular offices or may operate entirely based upon negotiated appointments. If the clinician is using an online calendar system (such as found in the patient portal), available appointment slots may be reviewed there.
• Appointment slots are generally booked on a first come first served basis, meaning that if you wait until the last minute to book an appointment, you are less likely to get the one you desire.
• Appointments may be made for individuals, couples, families (or specific parts thereof) or other groups of connected individuals. This generally is driven by the presenting problem and the assessed treatment plan. Before a client schedules for a different configuration, the client should discuss this with the clinician.
• Same day appointments do not show up in the online calendar system and may well not be available.
• Clients are expected to manage (make, change and cancel) their own appointments. The following methods may be available to you to do this:
o the online calendar system
o representatives at the answering service
o reaching your clinician through their phone number
o making appointments at the end of your session
• Clients may book more than one advanced appointment (for example if they want to establish a regular appointment slot). This opportunity may be restricted if the client has an excessive number of cancellations.
• If there are no appointments available when you want, your clinician will let you know if a cancellation occurs if you ask make that request of them. Calendar exceptions to schedule appointments outside normal times can only be made by the clinician involved.
• If an appointment is cancelled and not rescheduled or if too long passes between appointments, your clinician may attempt to contact you (or your emergency contact) to determine what is going on.

Dealing with Clinician Absence
There will be occasions when a clinician will not be able to see clients.
• When a clinician has a planned absence of more than a day or two, the clinician will attempt to inform you in advance. Together the client and clinician will discuss details of how things will be covered during the absence. During planned absences, the gap may be addressed in different ways such as a gap between sessions, conducting of session(s) by telephone or electronic means, or another clinican providing emergency sessions and/or coverage of sessions.
• There are times when a clinician will have an unplanned absence. In these cases, we will attempt to contact affected clients as soon as we know and are able to reach out. Most of these (such as illness or transportation problems) only affect a small number of days. In these cases, clients may elect to reschedule the missed session or may chose to simply wait until the next scheduled session.
• In some cases, a clinician may be unavailable for an extended period of time without this having been anticipated. In these cases, the clinical director (or other clinicians) will work with clients to make sure that continuity of care is able to be provided.

Lateness Policy
Lateness can occur on the part of the client or the clinician, especially in a city with as complex of transportation issues as we have. While they are handled differently, similar grace exists behind each of the responses.
• Clients are responsible for coming to each session on time and at the time scheduled.
• A time block has been reserved for that client and that client only to be together with the clinician. Respect for this aspect of our work together is appreciated.
• Elsewhere, being late for a therapy appointment would result in talking for the whole session about the lateness. It would be presumed that there are therapeutic issues behind a client being late, such as trying to avoid talking about particular topics. We will generally not have these conversations unless a client’s lateness is or becomes habitual.
• When a client is late, the clinician may elect to extend the client’s appointment beyond the end time, that may not always be possible based on other people’s appointments, other obligations of your clinician or other factors in the therapeutic relationship. As a result, if you are late, you should expect that you will have a shorter appointment and still plan for your appointment to end on time.
• Clinicians will attempt to contact clients, at least by text, to let them know that they are expecting to be arriving late.
• It is not fair to the client for the client’s appointment to be shortened if the clinician is late. If a clinician is late, they are expected to work with clients face to face back to back while pushing administrative and record keeping time to later. In this way the clinician will be able to catch up on their schedule.

Cancellation Policy
Our work together is most effective when meeting times are regular and consistent. There are people whose life schedule requires them to have a less regular or consistent schedule of appointments. Regardless, once you have scheduled an appointment, the time scheduled for your appointment is assigned to you and you alone. As a result it is not available to anyone else who wants to get help.
• Please give at least 24 hour notice if you cannot attend your session if it is a weekday daytime appointment.
• Please give at least 36 hours notice if the appointment is after 5:00 pm or on the weekend.
• Providing this amount of notice allows us to contact someone who has told us they would like to come at that time but were not able to get an appointment.
• You will be charged a Session Reservation Fee (which is the full fee for the session missed) for missed sessions or sessions that are cancelled without adequate notice. It should be noted that these fees are generally not reimbursed by third party payers like insurance companies.
• Naturally, should an unforeseen emergent situation arise, this may be taken into account. Frequent true emergencies will not be repeatedly taken into account.

Financial Matters
Fees
Seeking Shalom is primarily funded from client fees. Some clients will have a portion of their fees paid by a third party (such as an insurance company or an employee assistance program). However, we believe that it is usually important for those who receive a valued service to pay at least a portion of the cost of their therapy.

Standard fees are determined for each service for each office location. As a result, the standard fee charged for a session in one office may be different than the same session conducted in a different office. Additionally, different services may have different fee structures. For instance, in most cases the fee charged a participant for a group session will be half or two thirds the fee charged for an individual, couple or family session that lasts a similar amount of time. Currently, the standard fee for most sessions is $150 in Manhattan, $150-180 for sessions via technology (because of the technology fee) and $100 in the Bronx. For clients that receive services at multiple locations (regularly or on an occasional basis), a fixed fee schedule may be agreed upon for the client that does not vary based on the location where services are rendered.

In addition to fees directly associated with sessions with clinicians, there are a number of other fees that a client may be charged, although many clients will never face any of these fees:
• Session Reservation Fee: This is a fee for reserving a clinician’s time that is then not used for a clinical session. It is not charged if the session is cancelled or rescheduled in a timely fashion. It is generally equal to the clinician’s full fee, which may be higher than the client’s normal share of the cost of a session.
• Copying Fee: A fee of not less than fifteen cents per page is charged for copies made from the client’s record. If additional time is needed to compile information, fees for report writing will also apply. Fees for mailing copied documents will be no more than twice the rate of postage or shipping.
• External Documentation Fee: A fee may be charged to provide documentation to external sources about services received, outcomes reached and/or client participation. Clients may have access to some documentation through the communication methods provided without charge. Fees for simple documentation will usually be around $5-20.
• Report Writing Fee: Time spent writing a report for or on behalf of a client will be billed by the clinician at the same hourly rate as a regular visit. All associated time will be billed including that for chart review, research and writing, as well as the time of other clinicians that may also be involved (which is usually applicable if the clinician has a clinical supervisor).
• Fees for Testifying and Appearances Related to the Client (including Court Appearances): Clinicians appearing or testifying related to the client are time intensive activities that remove the client from being available to help other clients. Depending on the setting, they may also require a larger block of time to be dedicated to the testimony or appearance than would initially seem to be involved unless one is aware of how these formal systems work.
o When a clinician is scheduled for a deposition, to appear in court or to otherwise be involved in a legal or administrative matter, this fee shall be based on the minimum of sixteen times the full hourly cash fee of the office. Half of this fee shall be for preparation (which is nonrefundable after making the request) and half shall be for the availability of an appearance (which shall be 50% refundable up until a week before the scheduled appearance). Each day of continuance or rescheduled appearance shall incur an additional availability of appearance fee at a minimum of ten times the full hourly cash fee. Excessive preparation, transportation costs (using means determined by Seeking Shalom), document copying and preparation, time of supervising or cooperating clinicians, and appearance availability on special days (when the clinician is regularly scheduled for more than six hours or is not normally scheduled) will be additional charges above the basic minimum fee.
o If a clinician is scheduled to attend other types of meetings, the minimum fee shall be three times the full hourly cash fee for preparation and an availability of appearance fee for all scheduled hours based on the full hourly cash fee. Refundability and additional fees shall be as in the above bullet.
o Ordinarily, an appearance will not be added to a clinician’s calendar until all fees (except those that will be vouchered after the appearance) have been paid. In the case where the client consists of multiple people (e.g. a couple), each shall be individually liable for these fees until the fees have been paid in full. The above fees will be charged to the client whether the appearance is scheduled at the client’s request or as the result of the clinician being compelled to appear. If in the clinical judgment of the clinician there is a therapeutic value for the appearance in a particular case, an alternate fee schedule may be considered by the clinical director, but only if worked out in advance.
• Technology Fee for Sessions Using Technology (telephone, video, computer): while these are technically a different service, it should be noted that when service is provided using technology, the fee for the service is usually higher than the fee for the equivalent face to face session, with the differential typically being 20%.
• Emergency Contacts Fee: These fees are for sessions that are of on an emergent nature (including non-face-to-face crisis interventions and most sessions scheduled within twenty-four hours of the appointment). These fees are usually double the normal rate. They will be billed in quarter hour increments with a half hour minimum. Coaching calls done at the time a client faces a particular situation may be considered emergent calls or may be considered as regular sessions using technology, please consult with your clinician.
It should be noted that many or all of these other fees may not be covered by third party payers and will be the responsibility of the client.

Reduced Fees
Some clients have fees that are reduced as part of the way that they came to Seeking Shalom:
• Some referral sources (especially third party payers) may have negotiated reduced fees.
• Some clients may receive financial assistance for their fees from their religious body or other referral source.
• Seeking Shalom may offer reduced fees to clients that are referred to Seeking Shalom by leaders of faith groups that have partnered with Seeking Shalom.
• Clinicians in Seeking Shalom may participate in programs that provide pro bono or reduced fee sessions, but these are for clients meeting specific criterion and such opportunities will be limited.
• Other clients may have a session fee that is temporarily reduced from standard fees based on their proven life situation) established as part of the intake process. Temporarily reduced fees will be periodically reviewed and documentation of ongoing need established.
Clients who have a reduced fee may be charged the full fee and will be liable for that full fee until all payments associated with the reduced fee are received, at which time the excess will be written off. Even more important than the liability portion of this, clients reviewing their account should be aware of the way these charges are processed.

If your life situation should change after the initial session, please feel free to discuss this with your clinician in one of your sessions. The clinician may also raise this periodically as part of the therapeutic process.

Seeking Shalom also operates special programs that may have reduced fees associated with them:
• Journey to Peace: This is a program established by Seeking Shalom in the Bronx. It is the result of our commitment to be a part of quality mental health care in Northern Manhattan and the Bronx, communities that have traditionally been underserved in this regard. It also arose out of our desire to help residents in these local areas overcome the stigma of seeking care that can help them find wholeness in their lives. Individuals without adequate health insurance (or none) or without reasonable access to mental health care through their own insurance who are from these communities qualify. The program is designed to provide service through interns (or residents) at a total fee that is comparable to many copays (usually $30 for a dedicated session and $20/person for a group session).
• Special Programs: Seeking Shalom may also operate other special programs involving reduced fees, especially in partnership with other community groups or connected to special passions of particular clinicians.

Insurance/Third Party Payers
For those who are considering using their insurance, there are a number of factors that they need to think about and will affect how this will relate to their care at Seeking Shalom.
Do you want to use your insurance?
• There are financial benefits of doing this and they are benefits that you or someone else has already paid for.
• There are downsides of using insurance, including some loss of privacy (information about your care is shared with the insurance company) and possible consequences of the way this information can be used in the future (a common concern is about the fact that insurance requires a diagnosis and depending on the diagnosis this can be a red flag when applying for certain things in the future).
• A more detailed information sheet about the use of insurance is available on the website.
Will your insurance cover the type of services you need and for the reasons that you would need them?
• As mentioned above, there are some fees that insurance will not assist with.
• There are some services that many insurance companies do not provide any reimbursement for, for example services provided through the use of technology or couples/marital therapy (as this is for two people and not just one person).
• Even when covered, there may not be any benefits provided by the insurance company unless you will be meeting your deductible amount for the year.
Will your insurance company provide reimbursement for covered services if they are provided here at Seeking Shalom?
• Generally for a covered service to be able to be reimbursed at Seeking Shalom, you will need to see a clinician that is in network for that insurance company (or on that company’s panel). Not all of our clinicians are on insurance panels and those who are may not be on all of the panels that are listed on our website, so it is important to check about whether your clinician is on the panel of your insurance company.
• The best source for network participation is the insurance company themselves. However, a list of networks that some clinician participates in is available on our website.
• Even if the clinician is in network with your insurance company, you should check with your insurance company to make sure that your clinician is in network for your particular plan and for the types of services you are planning to get at Seeking Shalom.
Can I still get reimbursement from my insurance company if my clinician is not in network with them?
• Some insurance plans (although this is a declining number) will offer coverage for services received out of network. You can check with your insurance company to see if they do.
• If your insurance company is one that your clinician is in network with, you would be expected to pay for your services and use the bill we can provide to apply to your insurance company to be reimbursed directly.
A guide with some questions to ask your insurance company about your coverage is provided on the website.

If you are using a third party payer (including insurance), it is the responsibility of the client to ensure that Seeking Shalom and their clinician is in network for them. Clients intending to utilize in network benefits must let their clinician know in the first session or at least before they plan to use them. A form to provide information about your coverage will need to be filled out. If you do not fill this out and provide it to your clinician, it is presumed that you will not be using insurance or other third party payment to cover the cost of your services. In that case, you agree to pay the full fee, to not hold Seeking Shalom liable for any refund associated with rates negotiated with your third party payment source, and for any payments that your third party payer requests from Seeking Shalom. Retroactive use of third party payment is generally not available.

Seeking Shalom will also cooperate with you in the filing of claims to your insurance company, however the services here may be considered out‐of‐network and we do not usually take assignment of insurance benefits. The only third parties that we accept assignment from are companies for which we are in-network providers or others for which we have specific agreements. When we do accept assignment, you will still be responsible for your copay and deductibles and you will also still be responsible for paying the entire fee if your insurance (or other outside payment source) fails to authorize units of service, if no units of service are available to you, declines coverage based on the specific service rendered or coverage is otherwise denied.

As long as amounts remain unpaid by third parties, the entire charge (less the amount paid by the client) will remain on the client’s account balances. Offsets for any difference between the full fee and a contracted rate will only be made when the third party makes its payment. As a result, given that Seeking Shalom does not necessarily bill immediately after service and that some third parties can take months to pay, a client’s account balance may include fees connected to many sessions.

Payments Made by Clients
We ask that you make payment at each session. No sessions can be scheduled beyond the second visit without payment unless special arrangements are made. Payment may be made in cash or in other forms agreed upon.

In person payments may be made using cash, check (payable to “Seeking Shalom”) or credit card. If a payment form is declined or returned as unable to be paid, the client will be responsible to provide payment immediately to cover the amount that was not collected as well as any resulting fees that this created. Even if a clinician or location regularly accepts a particular form of payment, we reserve the right to not accept that form from a particular client, especially if there have been problems with collection in the past.

If your clinician accepts credit cards at your location, this is done as a convenience for you (and at our cost). You should be aware that there are limitations on your confidentiality and privacy that can come from use of a third party processing system. Clients should especially be aware that some systems automatically send electronic receipts and may send them to an address on file with that processor and as such Seeking Shalom does not control where that information may go.

We may offer you the availability of having your financial responsibility settled to a credit card automatically. If we offer this option, we will provide a form for you to complete to authorize this. Similarly, we may require clients in particular programs, at particular locations or associated with specific characteristics (such as third party payers) to provide authorization for us to charge a credit or debit card if a balance remains unpaid.

Should a balance accrue and no payment be received, we reserve the right to seek remuneration by any means legally possible including, but not limited to, the retention of a collection agency and/or seeking legal action against you. It is our desire that this situation not be allowed to develop.

Payments are usually made during the clinical session. In some programs, participants may pay for the entire program up front. The online client portal or the website might also provide a way to make an electronic payment (and we may send automatic invoices to clients who have balances they may be responsible for). Additionally, clients may mail payments to the administrative/billing address in the contact section. In any case, payment should be made at or before the time of service.

Clinical Matters

Assigned Clinician
• Clinician Assignment: Each client will be assigned to a primary clinician who will be responsible for their care and the overall treatment plan. A client may have additional clinicians, especially if more than one type of therapy is being pursued or multiple issues are being addressed.
• Initial Assignment: The clinician initially assigned as the primary clinician may or may not be the same as the clinician seen in the intake session. The decision for the initial assignment will be made based on specialties of different clinicians, what would be best for the client, comparative schedules and availability of the clinician and client, and other relevant factors.
• Change of Clinician: If a client feels that a particular primary or additional clinician is not a good fit for them, they should discuss this with the clinical director (possibly after discussing it with the clinician). When appropriate and feasible, a change may be made at the decision of the clinical director. Similarly, the clinical director may make a change without the prompting of the client based on factors that the client may not even be aware of.

Confidentiality
Your relationship to your clinician and to the center is a personal and private matter. On occasion your therapy may be assisted by requesting information from other professionals with whom you have had contact. No contact will be made with any outside person and/or agency without your written permission, except in the event of danger to self or others or if required in one of the situations discussed in our Notice of Privacy Practices.

When therapy is focused on a couple (married or otherwise) or a family unit, one person may be formally designated as the client (especially with a third party payer) but the couple/family will be considered as a clinical unit. Everyone involved in a clinical unit need to consent to their involvement in treatment and the clinician will see one or more people without everyone being present. When this occurs, it is assumed that anything revealed when everyone is not present may be shared with those who were not present, effectively providing a release of information to the other party, unless an explicit agreement is reached that confidentiality will be maintained and the information will not be shared. Even if one or both individuals are seen individually, a common file will normally be maintained for the couple/family. As a result, normally all parties will have to consent or assent to a voluntary release of information.

Emergencies
Clinicians will attempt to be available between sessions if a client has a clinical emergency but we are not set up to provide around the clock availability for care on a 24/7 basis. You may try to reach your clinician by the contact methods above, but know that your clinician is likely to not have access to your records when they speak with you. Note that if your clinician uses the answering service or other shared contact method, you may be helped by another clinician who also may not have access to your records.

If the situation is critical and/or life threatening, please call 911 and/or seek assistance at your local emergency room. This is especially the case if you are at a risky or unsafe place in your feelings, or if you have a desire to hurt yourself or someone else. If you need outside help, we will cooperate with outside services so that you can get the help you need.

The Process of Therapy
There are several aspects about the process of therapy that a client may want to be aware of:
• Working Towards Benefits
o Participation in therapy can result in a number of benefits to you, including interpersonal relationships and resolution of the specific concerns that led you to seek therapy, however such outcomes are not guaranteed.
o Working towards the possible benefits, however, requires effort on your part.
o Psychotherapy requires your very active involvement, honesty and openness in order to change your thoughts, feelings, and/or behavior. Your clinician will ask for your feedback and views on your therapy, its progress and other aspects of the therapy, and will expect you to respond openly and honestly.
o During therapy, remembering or talking about unpleasant events, feelings, or thoughts can result in you experiencing considerable discomfort or strong feelings of anger, sadness, worry, fear, etc.
o You may also experience anxiety, depression, insomnia, etc. Your clinician may challenge some of your assumptions or perceptions, or propose different ways of looking at, thinking about, or handling situations that can cause you to feel upset, angry, challenged, depressed or disappointed.
o Because you are dealing with things you previously chose to avoid, the beginning of therapy can be tricky. In fact, some, but not all, clients experience that things get worse before they get better, in part because of facing these feelings before healing begins. This is a normal part of the process. Change will sometimes be easy and swift, but more often it will be slow and frustrating. There is no guarantee that psychotherapy will yield positive or intended results.
• Unexpected Consequences
o Attempting to resolve issues that initially brought you into therapy (such as personal or interpersonal relationships) may result in changes that were not originally intended and may reveal other issues to be addressed in therapy. Psychotherapy may result in decisions about changing behaviors, employment, schooling, substance use, housing or relationships. Sometimes a decision that is viewed as positive by one family member may be viewed quite negatively by another.
o There are no guarantees with therapy, so we cannot tell you that a particular outcome will be the result of going through therapy.
• Alternative Treatment
o Sometimes more than one approach can be helpful in dealing with a certain situation. During the course of therapy, your clinician may draw on a variety of psychological approaches which he or she is qualified to utilize. These approaches will be selected based, in part, on what is being treated and their assessment of what will be of benefit to you. Their approaches may include but are not limited to behavioral, cognitive, psychodynamic, systems/family, developmental and/or psycho‐educational techniques. There may be times that the situation and/or technique indicates that the clinician will suggest the inclusion of another person in the therapeutic session.






Treatment Process
There is a general flow of treatment that most clients progress through. These stages include:
• Coming to Treatment: The process begins with you making your first appointment and providing some basic information about your background and what is bringing you in to the office.
• Evaluation: The first few sessions involve a comprehensive evaluation of your needs and situation. By the end of the evaluation, you will be provided with some initial impressions of what the work together might include. Between the first and the second session, you can expect to prepare additional information about your background – your clinician will give you guidance about this.
• Treatment Plan: Within a reasonable period of time after the initiation of treatment, your clinician will discuss with you their working understanding of the problem, treatment plan, therapeutic objectives and their view of the possible outcomes of treatment. If you have any unanswered questions about any of the procedures or techniques used in the course of your therapy, their possible risks, your clinician’s expertise in utilizing these procedures or techniques, or about the treatment plan, please ask and it will be answered fully. You also have the right to ask about other treatments for your condition and their risks and benefits. If you could benefit from any treatment that your clinician does not provide, and you desire to explore those options, your clinician has an ethical obligation to assist you in obtaining these treatments.
• Treating Towards Goals: Later sessions will be guided by the process described in the initial treatment plan. It is common for the frequency of appointments to be weekly, but this may be more or less frequent depending on your situation. Depending on your concerns and situation, sessions may be for an individual, a couple or a family unit.
Clinicians may provide brief, focused therapy (in which they have training and is required by some managed care organizations) and/or longer‐term, intensive psychotherapy when indicated by diagnosis.
• Terminating Treatment: You always have the option to terminate treatment at any time, for any reason. It is customary to discuss this with your clinician in session, so that any concerns either you or your clinician have may be adequately addressed. Likewise, if your clinician feels that therapy is not benefiting you, your clinician will discuss this with you.



Teaching Practice Processes

Seeking Shalom views itself as a teaching practice, an organization which is not only about serving our clients but also is about the training and development of clinicians, especially clinicians that incorporate spirituality into their therapeutic practice. This has some implications for the clinical care we provide.

Continuous Quality Improvement
Seeking Shalom believes that care must be carefully managed internally and engages in rigorous continuous quality improvement procedures including:
• Staff members and records are monitored regularly.
• Clinicians seek out peer review and supervision on a regular basis.
• Clients may also be asked to consult with a psychiatrist or another medical professional – in these cases close collaboration is maintained.
• Similarly, when indicated, we collaborate with other area professionals, including religious leaders, in order to ensure that the best possible care is provided.
Clinicians may also be concerned about particular aspects of something a client says in session. Without understanding the background or context of the situation (especially if concerning a culture or situational context the clinician is less familiar with), the clinician may not know the best way to proceed and when the clinician may not consider it appropriate to ask the client without starting down one particular path with the client. In these cases, the clinician may ensure the client is in a temporarily safe place and check out the context of the situation (as anonymously as possible) using external resources and people. This will help guide the clinician in how to proceed in the next session.

Recording and Live Supervision Possibility
To assist with this, the clinician may make an audio and/or video recording of the session that may be destroyed afterwards. Clients may request at any session that a recording not be made of that particular session, which the clinician will let them know if they are able to comply with or not. There are times and situations where a clinician need to be able to make recordings. Clients agree not to make a recording of a session without the express permission of the clinician at each session that will be recorded.

Clinicians Under Supervision
Pre-licensed clinicians (and some clinicians working on further qualifications) will have a clinical supervision within Seeking Shalom. The supervisor will regularly review the clinician’s practice including reviewing cases the clinician is seeing. Clients of pre-licensed clinicians will also be considered clients of the supervisor and will be given information of who that supervisor is and how they can be contacted in case the client needs to speak with the supervisor.
Some clinicians may also have a supervisor or other method of reviewing their development and work that is outside of Seeking Shalom. Information about this will also be shared with that clinician’s clients.

Affiliation to Higher Learning Institutions
Seeking Shalom is not a division of any institution of higher learning. We do cooperate with different institutions and may enter into agreements with them, especially when serving as a site for their students to complete practicums and/or internships. If you have any questions about whether we are affiliated with a particular school or institution currently, please ask your clinician.


Advantages and Disadvantages of Seeing a Pre-licensed Clinician
We believe clients receive quality care when seeing pre-licensed clinicians and benefit from this just as the pre-licensed clinicians benefit from being in a teaching practice. If we did not have this belief, we would not incorporate pre-licensed clinicians into our clinical staff. Having said that, we would like to share with you some of the advantages and disadvantages of your clinician being a pre-licensed clinician:
• such a clinician has less experience than a veteran clinician
• such a clinician will have a supervisor who will explain how their experience can inform the pre-licensed clinician’s treatment in your case
• your presenting issues may appear fresh to a pre-licensed clinician who may also be energized by this newness rather than appearing as just a variant on other cases to a more veteran clinician
• a pre-licensed clinician may still be developing in their ability to do certain things in treatment
• your treatment and how to improve will be reflected on by not only the pre-licensed clinician but also by their supervisor and possibly others, both in discussions and possibly through the review of how the pre-licensed clinician did through the recording of the session
• you may get the active involvement in your session, at times, of two clinicians, at no extra cost
• a pre-licensed clinician may not be a reimbursable provider for a third party payment source
• use of pre-licensed clinicians has allowed us to offer programs that would not otherwise be possible, such as where services are provided with low fees
• all clinicians, including pre-licensed clinicians, are guided by the clinical director and may incorporate spirituality into the therapeutic process
• pre-licensed clinicians are usually up on the latest developments in the field


Client Rights and Responsibilities

Clients have the right to receive services
• with respect for cultural and ethnic identity, religion, disability, gender, age, marital status and sexual preference,
• in a physical environment that is safe, sanitary, conducive to effective treatment and which appropriately safeguards the privacy and confidentiality of client/provider interaction,
• from providers who are qualified, competent, focused on each individual's care and are reasonably accessible to the client,
• free of unprofessional involvement with providers or staff,
• that emphasize client participation in developing a treatment plan that is specific to his or her needs, and
• that includes the client's agreement to work toward defined goals.
Clients have the right to certain information containing
• diagnosis, recommended treatment, benefits and costs in terms that the client can reasonably understand,
• names and credentials of providers involved in the client's care,
• practices that relate to client care and treatment services,
• client's responsibilities to ensure better treatment outcomes,
• records pertaining to the client's care, having the information explained or interpreted as necessary, except when protected or restricted by law, and
• resources available through Seeking Shalom for communicating concerns or questions and for resolving disputes, conflicts or grievances.
Clients have the right to protection of privacy and confidentiality
• in case of discussions, consultations, examinations and treatment services,
• in communications and records pertaining to care, except cases such as suspected abuse and danger to
• self or others, when reporting is permitted or required by law, and
• in cases where clinical information is important to share to assure medical appropriateness, such as to a referring primary care physician, needed signed release will be obtained from the client. The confidentiality of the information will be emphasized when any information is released. Clients with concerns about treatment may call the clinical director at (212)655‐9605.
Clients have the responsibility to engage in therapy and fulfill their obligations
• to be open and engaged when meeting with their clinician,
• to risk vulnerability in order to allow the therapeutic process the chance to work,
• to complete assignments and practice techniques between sessions,
• to maintain appointments on an agreed upon schedule and to come on time,
• to comply with all practices including meeting financial obligations, and
• to assist their clinician in evaluating their progress and need for further services.
Applicability of This Information and Changes to These Practices

Relationship of Entities Comprising Seeking Shalom
• Seeking Shalom was founded by the Rev. Christopher L. Smith, LCAC, LMHC, LMFT in order to provide services in particular locations and to promote the inclusion of spirituality in the therapeutic process. It has progressed to offer services over a wider geographic area and to be a teaching practice.
• In recent history, New York requires professional corporations for mental health practitioners to be for a single profession. As both marriage and family therapy as well as mental health counseling are practiced at Seeking Shalom, two separate corporations exist in New York and they cooperate together through a third entity.
• Given that Seeking Shalom is operating in more than one state, Seeking Shalom of Indiana, Ltd. was formed for operations in Indiana.
• Presently, Christopher continues as clinical director of all of the entities. Individual clinicians are involved in one or more of the entities.
• All of the entities work together in a way that clients normally experience as seamless and you are not likely to even be aware of these relationships. The assignment of clinical cases to entities has to do with geography, presenting issues and treating clinician – this is essentially an administrative matter that is not seen by the client.
• If you want to know under which entity your treatment falls, you can ask your clinician.

Applicability of this Information
• This information and description of our practices applies to Seeking Shalom including the following entities: Seeking Shalom Marriage and Family Therapy, P.C. (New York), Seeking Shalom Mental Health Counseling, P.C. (New York), Seeking Shalom New York (New York), and Seeking Shalom of Indiana, Ltd. (Indiana). It shall also apply to their clinicians and staff, including the Rev. Christopher L. Smith, LCAC, LMHC, LMFT.
• The Effective Date of this Notice is August 15, 2015.
• We can change this information and practices, and any such changes will apply to how we work together going forward. The new notice will be available upon request, in our office, and on our web site. If you continue to see a clinician or otherwise receive services after a change in this document or a change in the “Privacy Policy”, you will have agreed to the new terms. If you do not want to agree to the new terms, please speak with your clinician who will either provide a mechanism for you to be excluded from that condition or help facilitate an appropriate referral for you to continue treatment elsewhere.
• Other information related to our practices and your experience as a client may be founds in our “Privacy Policies” may be found in the companion document “Client Information and Office Practices”. This document also contains our contact information.
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