Informed Consent
NorthEast Health Services
Client-Provider Service Agreement
Thank you for choosing NorthEast Health Services, LLC (NEHS). We realize that starting treatment is a major decision and you may have many questions. This document contains important information about our professional services and business policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law that provides privacy protections and patient rights about the use and disclosure of your Protected Health Information (PHI) for the purposes of treatment, payment, and health care operations. Although this document is long and seemingly complex, it is very important that you read and understand it completely. When you sign this document, it will also represent an agreement between you and the agency. Your clinician will discuss any questions you have when you sign it or at any time in the future.
Therapy is a relationship between people that works in part because of clearly defined rights and responsibilities held by each person. As a client in therapy, you have certain rights and responsibilities that are important for you to understand. There are also legal limitations to those rights of which you should be aware. We, NEHS, have corresponding responsibilities to you. These rights and responsibilities are described in the following sections.
Mission Statement
NorthEast Health Services, LLC provides the best possible mental health care to members of the community regardless of challenges in their lives due to poverty, victimization, substance abuse, physical or mental illness and developmental or cognitive delays. We believe that such care should be provided by well-trained clinicians in professional clinic offices and in community settings including schools, day programs and residential settings as appropriate.
In order to provide this access to excellence in care, we are committed to the development of an organization in which all staff members are continually expanding their knowledge and skills through education and consultation. We strive to integrate with schools, social service organizations and other health care providers to ensure optimal networks of support for each of our clients.
Goals of Therapy
The first few sessions will involve an evaluation of your needs. By the end of the evaluation, your therapist will be able to offer you some initial impressions of what the work will include and goals that could be worked toward. It would be to your benefit to evaluate this information along with your own assessment about whether you feel comfortable working with your assigned therapist. Psychotherapy involves a significant commitment of time, money, and energy, so you should be careful about the therapist you select. If you decide to discontinue your work with the current therapist, we will help you secure an appropriate consultation with another therapist within NEHS or refer you to an alternative agency in your area. You may be asked, however, to discuss the decision to transfer with your current therapist or the clinic director, in order to identify the issues prior to transfer. Please feel free to ask any questions or express any concerns as they arise. If you have concerns about your provider, your treatment or the evaluation or therapy is not what you expected, please discuss these issues with your therapist, then clinic director if you are not satisfied or need further assistance.
There can be many goals for therapy. Some of these will be long term goals such as improving the quality of your life, learning to live with mindfulness and self -actualization. Others may be more immediate goals such as decreasing anxiety and depression symptoms, developing healthy relationships, changing behavior or decreasing/ending drug use. Whatever the goals for therapy, they will be discussed and formulated through conversation between your therapist and you as to what you want to work on in counseling. Your therapist may make suggestions based on history and observation and together you will plan on how to reach the goals.
