Practice Guidelines and Policies:
The following are practice guidelines and policies I have set up in an effort to efficiently manage my psychotherapy practice. This information is offered to bring clarity around mutual responsibilities for the therapeutic relationship you are entering into.

There is a positive correlation between clarity in expectations and success of relationships. A helping relationship is equally influenced by such clear expectations and understanding.

Fees:
Individual Psychotherapy $85.00 per 45 minute session. Couple/Family Psychotherapy $100.00 per 45 minute session.

Payment:
Payment is due in full at the time services are rendered. Methods of payment may include cash or check (made out to Thomas Fronczak). For your convenience I do accept credit cards (VISA, MasterCard, AMEX, Discover). Missed session fees must be paid in full before a follow-up appointment will be scheduled. I realize that temporary financial problems may at sometime affect timely payment of your account. If this should occur, I encourage you to contact me promptly for assistance in the management of your account. If your account should go unpaid and be without a payment arrangement, you will be subject to referral to a collection agency and/or legal action.

Returned check fee:
Returned checks will be subject to a $29.00 service charge.

Missed Appointments:
I ask that if you need to change or cancel an appointment time that you kindly give 48 hours notice by phone, as others may be able to utilize that time slot. Regardless of reason, you will be charged in full for sessions canceled or missed with less than 48 hours notice.

I have 24 hour phone service with voice mail available for convenience if you need to cancel or reschedule an appointment.

If there are 2 missed appointments without notice your therapy will be terminated with this office and you will be given a referral to other qualified mental health providers. If you will be late for an appointment, please let me know as soon as you are aware.

Billing:
I can provide you with a monthly statement of your account if requested. If you are able to submit session information directly to your insurance company for reimbursement consideration, your statement will include all necessary information to assist with filing your claim.

Emergency/Crisis Contacts:
In the event of a psychiatric emergency immediately go to the Emergency Department of the nearest local hospital. You may dial 911 for assistance or contact Crisis Services at (716) 834-3131.

My after hours contact number is (401) 431-2953, for emergent situations only. Please note professional fees ($85/hr. or prorated) apply for emergent phone contact after first 5 minutes. If I will be out of the office for an extended period of time, I will have licensed professional backup whose judgment I trust for any urgent need that may arise.

Report, Letter or Email Writing Fees:
There will be a professional fee applied ($85/hr. or prorated) for reports, letters or emails reviewed or written on your behalf to other providers, agencies, or organizations. There is no fee for the initial or follow-up letters to your primary care provider around your participation in therapy or coordination of medication management issues. Please note insurance does not cover report or letter writing fees.

Social Media Policy:
In an effort to protect your privacy and maintain confidentiality, I have a policy whereby I do not accept friend or contact requests from current or former clients on any social networking site (Facebook, Twitter, LinkedIn, etc). While I appreciate the positive thought behind any invitation, I believe it may blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up and I'd be happy to speak more about it with you.

Revised: 6/1/2014