NO SURPRISES ACT & GOOD FAITH ESTIMATE
Clients may choose to pay out-of-pocket for services for a variety of reasons. This document serves to inform you of definitions and policies and provide an estimate for services based on the full fee rate. During your first session, your provider will review your fee rate and provide you with a personalized Good Faith Fee Estimate.
The Good Faith Estimate (GFE) is only required to be provided to self-pay (out of pocket/non-insurance) clients. In accordance with the “No Surprises Act”, Section 2799B-6 of the Public Health Service Act, which went into effect 01/01/2022, healthcare providers are required to provide a “good faith” estimate of expected charges for services to individuals not enrolled in a plan or coverage or a federal health program, both orally and in writing.
This paperwork serves as an in writing “good faith” estimate for services rendered. As part of this paperwork, you will also receive a master list of charges that could prospectively be billed and their full pricing so you will reasonably know the absolute most you could be paying for any given service. Given the nature of therapy services, typically exact estimates are difficult to predict due to not knowing severity of symptoms, recommended frequency of services, length of time of services, and any other variables.
The GFE shows costs of services that are reasonably expected for your healthcare needs. This estimate is based on the information known at the time the estimate was created. The estimate does not include any unknown or unexpected costs that may arise during treatment.
Clients will receive a new estimate at the start of every calendar year, if fees change, or if the frequency of sessions increases from the original GFE.
Patient Rights per the No Surprises Act:
Clients will receive the GFE to sign within the client portal. Clients are required to sign the document to acknowledge receipt of the GFE. Failure to complete documentation may result in the cancellation of appointments or dismissal from the practice.
Clients may choose to pay out-of-pocket for services for a variety of reasons. This document serves to inform you of definitions and policies and provide an estimate for services based on the full fee rate. During your first session, your provider will review your fee rate and provide you with a personalized Good Faith Fee Estimate.
The Good Faith Estimate (GFE) is only required to be provided to self-pay (out of pocket/non-insurance) clients. In accordance with the “No Surprises Act”, Section 2799B-6 of the Public Health Service Act, which went into effect 01/01/2022, healthcare providers are required to provide a “good faith” estimate of expected charges for services to individuals not enrolled in a plan or coverage or a federal health program, both orally and in writing.
This paperwork serves as an in writing “good faith” estimate for services rendered. As part of this paperwork, you will also receive a master list of charges that could prospectively be billed and their full pricing so you will reasonably know the absolute most you could be paying for any given service. Given the nature of therapy services, typically exact estimates are difficult to predict due to not knowing severity of symptoms, recommended frequency of services, length of time of services, and any other variables.
The GFE shows costs of services that are reasonably expected for your healthcare needs. This estimate is based on the information known at the time the estimate was created. The estimate does not include any unknown or unexpected costs that may arise during treatment.
Clients will receive a new estimate at the start of every calendar year, if fees change, or if the frequency of sessions increases from the original GFE.
Patient Rights per the No Surprises Act:
- In accordance with Title I of Division BB of the Consolidated Appropriations Act, 2021 (CAA) amended title XXVII of the Public Health Services Act (PHS), Part E, this disclosure of patient protections against surprise bills ensures that consumers know their rights and ability to dispute. For consumers who get coverage through their employer (including a federal, state, or local government), through the Health Insurance Marketplace® or directly through an individual health plan, beginning January 2022, these rules will:
- Ban surprise billing for emergency services. Emergency services, even if they’re provided out-of-network, must be covered at an in-network rate without requiring prior authorization
- Ban balance billing and out-of-network cost-sharing (like out-of-network co-insurance or co-payments) for emergency and certain non-emergency services. In these situations, the consumer’s cost for the service cannot be higher than if these services were provided by an in-network provider, and any coinsurance or deductible must be based on in-network provider rates.
- Ban out-of-network charges and balance billing for ancillary care (like an anesthesiologist or assistant surgeon) by out-of-network providers at an in-network facility.
- Ban certain other out-of-network charges and balance billing without advance notice. Health care providers and facilities must provide consumers with a plain-language consumer notice explaining that patient consent is required to get care on an out-of-network basis before that provider can bill the consumer.
- For consumers who don’t have insurance, these rules make sure they’ll know how much their health care will cost before they get it, and might help them if they get a bill that’s larger than expected
- If you are billed for significantly more than this “good faith” estimate, you have the right to dispute the bill. You can contact us and notify that the charges are higher than the “good faith” estimate and ask us to update the bill or the estimate. You can also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the process within 120 calendar days of the date on the original bill. There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this “good faith” estimate. If the agency disagrees with you and agrees with the provider, you will have to pay the higher amount. To learn more and get a form to start the process, go to www.cms.gov/nosurprises or call 1-877-696-6775.
Clients will receive the GFE to sign within the client portal. Clients are required to sign the document to acknowledge receipt of the GFE. Failure to complete documentation may result in the cancellation of appointments or dismissal from the practice.
PROFESSIONAL DISCLOSURE STATEMENT
KRISTIEMARIE COUNSELING, LLC doing business as Sweary Therapy
Kristie Fuller, MA, NCC, LMHC
Florida License MH20191
Alaska License (LPC) 221286
www.swearytherapy.com
[email protected]
321-209-2332
v.05.01.2026
.
DISCLOSURE STATEMENT:
The following disclosure statement is provided to give you information about my background and the nature of our professional relationship. This document is meant to explain your therapist’s training, offer information about the counseling relationship, provide information about client rights and responsibilities, and outline the limits of confidentiality. This document must be signed by the client or by the client’s parent/legal guardian before counseling may begin. Some information contained in this document is clarified further in the additional intake documents you may have already reviewed. This document uses the term “therapist” and “counselor” interchangeably.
.
Introduction:
Your therapist is a graduate of the Master of Arts in Mental Health Counseling program at Wake Forest University (WFU). Wake Forest University’s counseling program is accredited by the Council for the Accreditation of Counseling and Related Educational Programs (CACREP) and consists of 60 semester hours of study, including the practicum and internship courses. This program includes training in many areas including the following: counseling theories and practice, human growth and development, diagnosis and treatment of psychopathology, human sexuality, group theories and practice, individual evaluation and assessment, career and lifestyle assessment, research and program evaluation, social and cultural foundations, counseling in community settings, substance abuse, and legal, ethical, and professional standards issues.
Your therapist also holds a master’s degree in General Psychology from American Public University and a Bachelor’s degree in Liberal Studies from the University of Central Florida.
.
Your counselor’s private practice is called Sweary Therapy. The practice is registered under the name KristieMarie Counseling, LLC and Sweary Thearpy is the registered fictitious name. A fictitious name is sometimes referred to as a DBA or “doing business as” name.
.
Your counseling services will be based on a relationship characterized by trust and respect. The counselor and client will work together to both identify goals for counseling and to move toward meeting those goals. The counseling sessions may include an exploration of thoughts, feelings, personal history, communication styles, attitudes and beliefs about self and others, and personal development needs. Some of these experiences may be uncomfortable for some clients. Your counselor is trained primarily to utilize person-centered, trauma-informed, mindfulness-based cognitive-behavioral therapy, and wellness approaches in counseling.
.
Clients have the right to receive counseling in which the individual’s dignity, worth, and uniqueness are respected. Your counselor will provide you with quality informed services that are evidence based. Additionally, the success of the counseling relationship depends on your willingness to be open and involved in the process. Individuals who participate in counseling can experience changes in personal views, attitudes, and coping skills. Sometimes those close to you may need time to adjust to the new perspectives and positive behavioral changes that may evolve during your counseling. Finally, clients have the right to receive services that are confidential, with the following exceptions.
.
Confidentiality:
Confidentiality is a crucial aspect of the professional counselor’s role and is therefore important for the client to understand the limits to this confidentiality.
It is important to clarify the special circumstances where confidentiality cannot be maintained. Confidentiality will conform to state guidelines and the ethical guidelines of the American Counseling Association. All counselors-in-training, their supervisors, and group supervision members will not disclose information except under the following conditions:
• The client or guardian gives written consent to release information to a designated individual or agency;
• The client makes specific violent threats to harm themself or to harm an identifiable victim;
• The counselor and/or their supervisors are named as defendants in a civil, criminal, or disciplinary action arising from the counseling session;
• The counselor receives an authentic subpoena backed by judicial authority that requires the disclosure of information;
• The counselor has reasonable cause to believe that a child or adult with a disability has suffered abuse or neglect;
• The counselor may share your information with other clinicians employed at this site for the purposes of case consultation. This sharing of information will only occur if it presents as beneficial for your development and growth. All clinicians are bound by the governing HIPAA laws and will comply with this confidentiality agreement.
• If you are under eighteen years of age, please be aware that the law may provide your parents the right to examine your treatment records. It is your counselor’s general policy to provide your parents/guardians only with general information about our work together, unless it is felt that there is a high risk that you are being harmed, will seriously harm yourself or will harm someone else. In this case, your parents will be notified of my concern, as well as the appropriate authorities if necessary. Before giving them any information, your counselor will discuss the matter with you, if possible, and do her best to handle any objections you may have with what she is prepared to disclose.
.
Fees & Expectations:
Session fees and length of service shall be determined by Sweary Therapy. Your counselor is contracted with several insurance companies and uses Alma to determine eligibility and collect co-pays. Clients are ultimately responsible for verifying their benefits and ensuring that the co-pay and other information provided by Alma is accurate. If there are any discrepancies between what the client was billed and what the insurance pays, the client is financially responsible.
The current fees are posted to your counselor's website and can be found online at https://www.swearytherapy.com/fees--services.html
See the Fees, Cancellation Policy, GFE, & Attendance Expectations for further information.
.
Your participation and attendance of each session is very important in order to obtain the greatest benefits of counseling. In addition, your counselor will spend time preparing for your visit to ensure that you have the maximum opportunity for growth in every session. In return, it is expected that if you have a challenge that prevents you from attending an appointment please call the office to reschedule the appointment with a minimum of 24 hours’ notice in order to avoid the cancellation fee. See the Fees, Cancellation Policy, GFE, & Expectations for further information.
Please note that insurance does not cover no-show or late cancellation fees.
.
Please know that your therapist understands that there may be incidences that arise that make your attendance unavoidable and these will be reviewed on a case-by-case basis.
.
Payment for services is required the same day as services are rendered. After each session, your card will be charged over night. For insurance clients, you are required to be enrolled in Auto-Pay with Alma, the billing company used by your therapist. Co-pays are generally invoiced within 72 hours by Alma.
.
Intake paperwork and consent forms are required from each client. The client will have until 24 hours prior to the start of the first session to complete the paperwork on their own and return it to the counselor via the client portal.
.
Coaching vs. Counseling
KristieMarie Counseling, LLC and Sweary Therapy both offer coaching in addition to psychotherapy services for clients. For the purposes of our work together, it is important that clients understand the difference between the two services.
Coaching is offered to clients who are stable, and who are in need of simple support. Setting goals, creating strategies for meeting goals, skill building & practice. Mindfulness meditation training/coaching, and general encouragement/cheerleading are common activities for coaching clients.
Coaching clients are not exploring deep emotions, history, trauma, or activities of that nature. For clients who wish to develop a deeper understanding of their thoughts, emotions, and behaviors, make sense of their past, and improve their ability to cope with mood symptoms, psychotherapy services are more appropriate.
Costs for coaching are posted to the website and the policy stated within this document applies to coaching and therapy clients alike.
-
Boundaries:
Although the session may be very intimate psychologically, it is important for clients to realize that we have a professional relationship. Contact will be limited to the sessions you arrange with me. It is vital for you to know that if I see you in public, I will protect your confidentiality by greeting you only if you greet me first.
In order to promote a healthy therapeutic relationship certain boundaries and policies have been established to ensure the safety, respect, and independence necessary for growth, nurture and understanding. Once we have entered into the counseling relationship together this will become our priority relationship and all other interactions will become secondary in nature and avoided if they do not directly contribute to the benefits of our therapeutic relationship.
Additionally, it is your counselor's policy to limit the duration of outside contact that is deemed unrelated to counseling such as "running into each other" in public and/or "friending" on Facebook or similar social network sites.
Please note that if a client chooses to follow a therapist’s online public profiles on social media, this poses a privacy risk to the client. Your therapist will not engage with you through social media in order to protect your privacy and maintain appropriate boundaries.
Emergency Contact:
Your counselor may not always be immediately available for contact by phone or email. Please feel free to leave a message and every effort will be made to return your call within 24 hours on weekdays and within 48 hours on weekends. If, for any reason, you feel that you need to speak with someone immediately, please see the emergency resources below:
• Emergency Service: 911
• Brevard County Crisis Hotline: 211
• National Suicide Prevention Lifeline: 988.
• National Domestic Violence Hotline: 1-800-799-7233
• Crisis Text Line: text the word “home” to 741741
.
Termination:
You are free to end, take a break from, or request a referral for treatment at any time. It is encouraged that you discuss your reasons for your decision with your counselor so that sufficient closure can be given to our therapeutic relationship, as well as allow for referrals to be made for treatment options that will best meet your needs. The laws and standards of my profession require that treatment records are kept for a minimum of 7 years. If you wish to see your records, it is recommended that you review them with your counselor so that you can discuss the contents together. You are responsible for any past due balances and copay invoices. Your card on file will be automatically charged within 60 days of your final appointment, after attempts to contact you have failed. Your therapist reserves the right to utilize a debt collections agency to recover unpaid balances.
.
Questions or Concerns:
If you have any questions or concerns, please contact your counselor. Your counselor may be reached directly via the messaging platform within the Simple Practice Client Portal. Clients may also chose to text the therapist at (321)-209-2332 or to email your counselor at [email protected], however, please be aware that your counselor cannot guarantee confidentiality of email or text communication. If you choose to communicate confidential information with your counselor via email, it will be assumed that you have made an informed decision and your counselor will view it as your agreement to take the risk that email may be intercepted.
Please be aware that email is never an appropriate vehicle of emergency communication. Do not use text, email or voicemail to communicate in a crisis. Please call 911 or Go to the nearest Emergency Room or use the crisis contact numbers listed above.
.
Although clients are encouraged to discuss any concerns with the counselor, you may file a complaint against the counselor with the organization listed below should you, the client, feel she is in violation of any of these codes of ethics. The Florida Department of Health has the general responsibility of regulating the practice of licensed psychologists, licensed social works, licensed mental health counselors, licensed marriage and family therapists, licensed school psychologists practicing outside the school setting, licensed or certified addiction counselors, and unlicensed interns who practice psychotherapy.
FLORIDA LICENSING BOARD:
Board of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling
Department of Health
4052 Bald Cypress Way, Bin C75
Tallahassee, FL 32399-3290
Phone: 850-245-4339
Email: [email protected]
Website: http://www.floridahealth.gov/licensing-and-regulation/enforcement/index.html
-
ALASKA LICENSING BOARD
12 AAC 62.930 – Written Notice with Disclosure Statement – In addition to the
professional disclosure statement required by AS 08.29.220, a licensee must provide
written notice to the client that the treatment program may be discussed with other
professionals and, if that occurs, the client’s confidentiality will be maintained; and
the name and identity of the client will be disclosed only in compliance with AS
08.29.200.
“This information is required by the Board of Professional Counselors which
regulates all licensed professional counselors”.
Board of Professional Counselors
Division of Corporations, Business & Professional Licensing
P.O. Box 110806
Juneau, AK 99811-0806
Phone: (907) 465-2551
-
CODE OF ETHICS: ACA
You may obtain a copy of the Code of Ethics from the American Counseling Association at www.counseling.org or by calling 1-800-347-6647
KRISTIEMARIE COUNSELING, LLC doing business as Sweary Therapy
Kristie Fuller, MA, NCC, LMHC
Florida License MH20191
Alaska License (LPC) 221286
www.swearytherapy.com
[email protected]
321-209-2332
v.05.01.2026
.
DISCLOSURE STATEMENT:
The following disclosure statement is provided to give you information about my background and the nature of our professional relationship. This document is meant to explain your therapist’s training, offer information about the counseling relationship, provide information about client rights and responsibilities, and outline the limits of confidentiality. This document must be signed by the client or by the client’s parent/legal guardian before counseling may begin. Some information contained in this document is clarified further in the additional intake documents you may have already reviewed. This document uses the term “therapist” and “counselor” interchangeably.
.
Introduction:
Your therapist is a graduate of the Master of Arts in Mental Health Counseling program at Wake Forest University (WFU). Wake Forest University’s counseling program is accredited by the Council for the Accreditation of Counseling and Related Educational Programs (CACREP) and consists of 60 semester hours of study, including the practicum and internship courses. This program includes training in many areas including the following: counseling theories and practice, human growth and development, diagnosis and treatment of psychopathology, human sexuality, group theories and practice, individual evaluation and assessment, career and lifestyle assessment, research and program evaluation, social and cultural foundations, counseling in community settings, substance abuse, and legal, ethical, and professional standards issues.
Your therapist also holds a master’s degree in General Psychology from American Public University and a Bachelor’s degree in Liberal Studies from the University of Central Florida.
.
Your counselor’s private practice is called Sweary Therapy. The practice is registered under the name KristieMarie Counseling, LLC and Sweary Thearpy is the registered fictitious name. A fictitious name is sometimes referred to as a DBA or “doing business as” name.
.
Your counseling services will be based on a relationship characterized by trust and respect. The counselor and client will work together to both identify goals for counseling and to move toward meeting those goals. The counseling sessions may include an exploration of thoughts, feelings, personal history, communication styles, attitudes and beliefs about self and others, and personal development needs. Some of these experiences may be uncomfortable for some clients. Your counselor is trained primarily to utilize person-centered, trauma-informed, mindfulness-based cognitive-behavioral therapy, and wellness approaches in counseling.
.
Clients have the right to receive counseling in which the individual’s dignity, worth, and uniqueness are respected. Your counselor will provide you with quality informed services that are evidence based. Additionally, the success of the counseling relationship depends on your willingness to be open and involved in the process. Individuals who participate in counseling can experience changes in personal views, attitudes, and coping skills. Sometimes those close to you may need time to adjust to the new perspectives and positive behavioral changes that may evolve during your counseling. Finally, clients have the right to receive services that are confidential, with the following exceptions.
.
Confidentiality:
Confidentiality is a crucial aspect of the professional counselor’s role and is therefore important for the client to understand the limits to this confidentiality.
It is important to clarify the special circumstances where confidentiality cannot be maintained. Confidentiality will conform to state guidelines and the ethical guidelines of the American Counseling Association. All counselors-in-training, their supervisors, and group supervision members will not disclose information except under the following conditions:
• The client or guardian gives written consent to release information to a designated individual or agency;
• The client makes specific violent threats to harm themself or to harm an identifiable victim;
• The counselor and/or their supervisors are named as defendants in a civil, criminal, or disciplinary action arising from the counseling session;
• The counselor receives an authentic subpoena backed by judicial authority that requires the disclosure of information;
• The counselor has reasonable cause to believe that a child or adult with a disability has suffered abuse or neglect;
• The counselor may share your information with other clinicians employed at this site for the purposes of case consultation. This sharing of information will only occur if it presents as beneficial for your development and growth. All clinicians are bound by the governing HIPAA laws and will comply with this confidentiality agreement.
• If you are under eighteen years of age, please be aware that the law may provide your parents the right to examine your treatment records. It is your counselor’s general policy to provide your parents/guardians only with general information about our work together, unless it is felt that there is a high risk that you are being harmed, will seriously harm yourself or will harm someone else. In this case, your parents will be notified of my concern, as well as the appropriate authorities if necessary. Before giving them any information, your counselor will discuss the matter with you, if possible, and do her best to handle any objections you may have with what she is prepared to disclose.
.
Fees & Expectations:
Session fees and length of service shall be determined by Sweary Therapy. Your counselor is contracted with several insurance companies and uses Alma to determine eligibility and collect co-pays. Clients are ultimately responsible for verifying their benefits and ensuring that the co-pay and other information provided by Alma is accurate. If there are any discrepancies between what the client was billed and what the insurance pays, the client is financially responsible.
The current fees are posted to your counselor's website and can be found online at https://www.swearytherapy.com/fees--services.html
See the Fees, Cancellation Policy, GFE, & Attendance Expectations for further information.
.
Your participation and attendance of each session is very important in order to obtain the greatest benefits of counseling. In addition, your counselor will spend time preparing for your visit to ensure that you have the maximum opportunity for growth in every session. In return, it is expected that if you have a challenge that prevents you from attending an appointment please call the office to reschedule the appointment with a minimum of 24 hours’ notice in order to avoid the cancellation fee. See the Fees, Cancellation Policy, GFE, & Expectations for further information.
Please note that insurance does not cover no-show or late cancellation fees.
.
Please know that your therapist understands that there may be incidences that arise that make your attendance unavoidable and these will be reviewed on a case-by-case basis.
.
Payment for services is required the same day as services are rendered. After each session, your card will be charged over night. For insurance clients, you are required to be enrolled in Auto-Pay with Alma, the billing company used by your therapist. Co-pays are generally invoiced within 72 hours by Alma.
.
Intake paperwork and consent forms are required from each client. The client will have until 24 hours prior to the start of the first session to complete the paperwork on their own and return it to the counselor via the client portal.
.
Coaching vs. Counseling
KristieMarie Counseling, LLC and Sweary Therapy both offer coaching in addition to psychotherapy services for clients. For the purposes of our work together, it is important that clients understand the difference between the two services.
Coaching is offered to clients who are stable, and who are in need of simple support. Setting goals, creating strategies for meeting goals, skill building & practice. Mindfulness meditation training/coaching, and general encouragement/cheerleading are common activities for coaching clients.
Coaching clients are not exploring deep emotions, history, trauma, or activities of that nature. For clients who wish to develop a deeper understanding of their thoughts, emotions, and behaviors, make sense of their past, and improve their ability to cope with mood symptoms, psychotherapy services are more appropriate.
Costs for coaching are posted to the website and the policy stated within this document applies to coaching and therapy clients alike.
-
Boundaries:
Although the session may be very intimate psychologically, it is important for clients to realize that we have a professional relationship. Contact will be limited to the sessions you arrange with me. It is vital for you to know that if I see you in public, I will protect your confidentiality by greeting you only if you greet me first.
In order to promote a healthy therapeutic relationship certain boundaries and policies have been established to ensure the safety, respect, and independence necessary for growth, nurture and understanding. Once we have entered into the counseling relationship together this will become our priority relationship and all other interactions will become secondary in nature and avoided if they do not directly contribute to the benefits of our therapeutic relationship.
Additionally, it is your counselor's policy to limit the duration of outside contact that is deemed unrelated to counseling such as "running into each other" in public and/or "friending" on Facebook or similar social network sites.
Please note that if a client chooses to follow a therapist’s online public profiles on social media, this poses a privacy risk to the client. Your therapist will not engage with you through social media in order to protect your privacy and maintain appropriate boundaries.
Emergency Contact:
Your counselor may not always be immediately available for contact by phone or email. Please feel free to leave a message and every effort will be made to return your call within 24 hours on weekdays and within 48 hours on weekends. If, for any reason, you feel that you need to speak with someone immediately, please see the emergency resources below:
• Emergency Service: 911
• Brevard County Crisis Hotline: 211
• National Suicide Prevention Lifeline: 988.
• National Domestic Violence Hotline: 1-800-799-7233
• Crisis Text Line: text the word “home” to 741741
.
Termination:
You are free to end, take a break from, or request a referral for treatment at any time. It is encouraged that you discuss your reasons for your decision with your counselor so that sufficient closure can be given to our therapeutic relationship, as well as allow for referrals to be made for treatment options that will best meet your needs. The laws and standards of my profession require that treatment records are kept for a minimum of 7 years. If you wish to see your records, it is recommended that you review them with your counselor so that you can discuss the contents together. You are responsible for any past due balances and copay invoices. Your card on file will be automatically charged within 60 days of your final appointment, after attempts to contact you have failed. Your therapist reserves the right to utilize a debt collections agency to recover unpaid balances.
.
Questions or Concerns:
If you have any questions or concerns, please contact your counselor. Your counselor may be reached directly via the messaging platform within the Simple Practice Client Portal. Clients may also chose to text the therapist at (321)-209-2332 or to email your counselor at [email protected], however, please be aware that your counselor cannot guarantee confidentiality of email or text communication. If you choose to communicate confidential information with your counselor via email, it will be assumed that you have made an informed decision and your counselor will view it as your agreement to take the risk that email may be intercepted.
Please be aware that email is never an appropriate vehicle of emergency communication. Do not use text, email or voicemail to communicate in a crisis. Please call 911 or Go to the nearest Emergency Room or use the crisis contact numbers listed above.
.
Although clients are encouraged to discuss any concerns with the counselor, you may file a complaint against the counselor with the organization listed below should you, the client, feel she is in violation of any of these codes of ethics. The Florida Department of Health has the general responsibility of regulating the practice of licensed psychologists, licensed social works, licensed mental health counselors, licensed marriage and family therapists, licensed school psychologists practicing outside the school setting, licensed or certified addiction counselors, and unlicensed interns who practice psychotherapy.
FLORIDA LICENSING BOARD:
Board of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling
Department of Health
4052 Bald Cypress Way, Bin C75
Tallahassee, FL 32399-3290
Phone: 850-245-4339
Email: [email protected]
Website: http://www.floridahealth.gov/licensing-and-regulation/enforcement/index.html
-
ALASKA LICENSING BOARD
12 AAC 62.930 – Written Notice with Disclosure Statement – In addition to the
professional disclosure statement required by AS 08.29.220, a licensee must provide
written notice to the client that the treatment program may be discussed with other
professionals and, if that occurs, the client’s confidentiality will be maintained; and
the name and identity of the client will be disclosed only in compliance with AS
08.29.200.
“This information is required by the Board of Professional Counselors which
regulates all licensed professional counselors”.
Board of Professional Counselors
Division of Corporations, Business & Professional Licensing
P.O. Box 110806
Juneau, AK 99811-0806
Phone: (907) 465-2551
-
CODE OF ETHICS: ACA
You may obtain a copy of the Code of Ethics from the American Counseling Association at www.counseling.org or by calling 1-800-347-6647