Your weekly appointment time is yours to keep. Should you cancel or postpone without a minimum of 24 hour notice, you will be charged the usual fee. If possible, an alternate appointment
may be scheduled at a mutually convenient day and time. The fee for canceled
appointments is due and payable at the beginning of your next scheduled appointment.
Therapy may be terminated after two consecutive cancellations.
I do not book sessions longer than two-hours, and I do not “make
up” time missed if you are late.
Please remember that I work in a private home. Be respectful of my family’s privacy.
Also be respectful of my clients. Please do not linger after your session
or come early. I open my front door ten minutes before my first session of the
day.
If you wish complete privacy, please exit and enter through the picket
fence to the right of the house. I will discuss this with you.
Fees
PAYMENT IS
REQUIRED AT THE BEGINNING OF EACH THERAPY SESSION. Please have your check written
before your session begins. I discuss my fees before we begin our work together.
My intention is to be honest and fair, and do not wish to cause misunderstanding or disappointment. I generally raise my prices $5 per hour at the beginning of each new calendar year. Please see the attached price list of my services. I keep
my fees reasonably low and competitive. A $25 fee will be charged for any returned
check.
Telephoning:
I
will do my best to return calls by the next business day. If I must schedule
a session by phone, I request that the client call me, if so scheduled. I charge
for calls over five minutes in length, so please be aware that calling me may incur charges.
I will remind you of this boundary if appropriate or necessary. Any long
distance calls are billed at my cost.
Confidentiality
Information
disclosed in a session is confidential, except when related to physical or sexual abuse of a minor or an elder, or when related
to danger to self or others. In family or adolescent counseling, I will share general information, but not private details,
with parents unless a breach of confidentiality is indicated for legal reasons. In
general, all information is kept in strict confidence, according to all Federal and State Laws.
Termination
I
have an ethical responsibility to continue our relationship as long as is reasonably clear that you are benefiting from the
relationship. We will need to discuss termination if you are unwilling to comply
with my therapeutic recommendations or if you do not maintain your agreed financial payment.
I request that you schedule a termination session, in person, and not over the telephone. Termination itself can be a constructive, useful process. It
is often one of the most beneficial processes of the entire therapeutic arrangement.
If a referral is warranted, it will be provided during the final session.
My Services
Please
see the attached sheet for a list of the services I offer, and the prices charged for them.
My
services to you may include nutritional advice, spiritual counseling, and other advice, but I in no way intend to provide
medical or psychological counseling, and my services do not relate to, and are not offered or intended to provide these forms
of treatment. My primary objectives for you include having you receive my support
in the awakening of consciousness. This may take place in many modalities of
treatment, such as on a massage table for energy balancing, or speaking one-on-one in a counseling format. Hypnotherapy clients may receive clinical support for issues
such as weight-loss, phobias, or the cessation of cigarette smoking, but these are goal - oriented sessions, and my desire
is to still frame all sessions in the light of spiritual counseling and the Awakening of Consciousness.
For all Living Essence Sessions: It is important
to understand that these sessions are always a minimum of two-hours for the first session, the first hour of which is “intake”
or counseling, and the second hour, after a short break, is intuitively revealed to me. It may include trance work, regression,
emotional cathartic work, deep relaxation, or meditation. Each session is different. If you have an intention for your session, it is imperative that you inform me before
your two hour session begins, in order that I may try to fulfill your expectation.
Please
be respectful of your time with me. Please leave promptly after your session. Please do not talk and bring up other topics after your last hour. It is imperative that you honor your process and leave in “silence”, as much as possible. Much of our work together happens after we are physically with one another. Please understand that activating the mind after a session can destroy some of the fragility of our time
together.
I
love working with each and every one of you. The awakening of consciousness is
the happy goal we all share.
Much
love, Gopita
My
fee for work with you is:
Signed:____________________________________Date:_____________
Therapist
Signed:___________________________________Date:_________________
Client
