Effective 07/01/2014 Welcome! Thank you for using our service. Please read the following agreement carefully. 1. Use Agreement Purposes and Agreement Requirements This is constitutes a legal binding agreement between Behavioral Health Innovation, Inc. ("BHI"), and you (referred to as "User" or "You") and contains important terms and conditions (referred to as "Terms" or "Agreement") for which you must agree in order to use the Services or Technology (referred to as "Site," "Platform," "Technology," or Service(s)"). You must be of legal age to enter into this contract. Legal guardians who register or agreed to the terms of the site take responsibility on behalf of the minor who is cited as the identified User in the Technology. BHI operates the Service operated over the internet that facilitates telehealth services between Users under these terms and conditions. "Providers" are Users who provide professional services to other Users on the Site. All relevant conditions of Users also apply to Providers. "BHI" includes all agents, representatives, owners, stakeholders, relatives, staff, contractors and affiliates associated with BHI. USE OF THIS SITE IS NOT INTENDED FOR EMERGENCY SERVICES. IF YOU NEED EMERGENCY MEDICAL HELP, DIAL 911 OR VISIT YOUR LOCAL EMERGENCY ROOM IMMEDIATELY. IF YOU ARE FEELING LIKE YOU MAY HARM YOURSELF OR SOMEONE ELSE YOU SHOULD CONTACT 911 IMMEDIATELY AND NOT USE THIS SERVICE. 2. Applicability and Site Usage By accessing and/or using the Service, You agree to be bound by and agree to comply with the terms and conditions of the Site, and maintain compliance with any and all applicable laws. Your access to any portion of the Site is conditional upon acceptance of these terms. Unless specified in an additional contract with BHI, all services are offered at the discretion of BHI and BHI reserved the right to suspended, rescind, revoke a User's license and stop Services and access to said Services and materials on the Service for any individual or group of User(s) at any time for any reason. BHI has the right to suspend or terminate any services offered by the Site at any given time regardless of notice. BHI is also not liable to any User or third party in regard to provided services.
Telehealth allows my/my child’s therapist to diagnose, consult, treat and educate using interactive audio, video or data communication regarding my/my child’s treatment. I hereby consent to participating in psychotherapy via telephone or the internet (hereinafter referred to as Telehealth) through Harmony Mental Health, Inc.
I understand I have the following rights under this agreement:
I have a right to confidentiality with Telehealth under the same laws that protect the confidentiality of my medical information for in-person psychotherapy. Any information disclosed by me during the course of my therapy, therefore, is generally confidential. There are, by law, exceptions to confidentiality, including mandatory reporting of child, elder, and dependent adult abuse and any threats of violence I may make towards a reasonably identifiable person. I also understand that if I am in such mental or emotional condition to be a danger to myself or others, my/my child’s therapist has the right to break confidentiality to prevent the threatened danger. Further, I understand that the dissemination of any personally identifiable images or information from the Telehealth interaction to any other entities shall not occur without my written consent. Regarding minors, parents or legal guardians of non-emancipated minor clients have the right to access the clients’ records.
I understand that while psychotherapeutic treatment of all kinds has been found to be effective in treating a wide range of mental disorders, personal and relational issues, there is no guarantee that all treatment of all clients will be effective. Thus, I understand that while I may benefit from Telehealth, results cannot be guaranteed or assured.
I further understand that there are risks unique and specific to Telehealth, including but not limited to, the possibility that our therapy sessions or other communication by my/my child’s therapist to others regarding my/my child’s treatment could be disrupted or distorted by technical failures or could be interrupted or could be accessed by unauthorized persons. In addition, I understand that Telehealth treatment is different from in-person therapy and that if my/my child’s therapist believes I would be better served by another form of psychotherapeutic services, such as in-person treatment, I will be referred to a therapist in my/my child’s geographic area that can provide such services.
I have read and understand the information provided above. I have the right to discuss any of this information with my/my child’s therapist and to have any questions I may have regarding my/my child’s treatment answered to my satisfaction.
I understand that I can withdraw my consent to Telehealth communications by providing written notification to Prepare to Change. By clicking agree and signing I indicate that that I have read this Agreement and agree to its terms.