Medical Disclaimer

Any and all content available on the Website of Michelle Valdner, LMHC, www.LiveHappyCounseling.com or the Instagram of Live Happy Counseling (@LiveHappyCounseling) including, but not limited to: text, images, audio, video, social media posts, blog posts, or any other format (hereinafter “Content”), is made available solely for educational and informational purposes only, and does not constitute medical or other professional health care advice, diagnosis, or treatment. Always seek the advice of a qualified health professional or provider with any questions you may have regarding a medical condition. Do not disregard professional medical advice or delay in seeking professional medical advice due to something you may have read within the posted Content. 

Reliance on any information posted on the Website or the Instagram of Michelle Valdner, LMHC is solely at your own risk. Michelle Valdner, LMHC  hereby disclaims any and all liability to any party for any direct, indirect, implied, punitive, special, incidental or other consequential damages arising directly or indirectly from any use of the Content, which is provided as is, and without warranties.

If you have or suspect that you have a medical or health problem or condition, please contact a qualified health care professional immediately. If you are located in the United States and are experiencing a medical or health emergency, please call 911 or call for appropriate emergency medical help.

Privacy Policy

Last updated on December 20, 2020.

We may change this privacy notice from time to time–when we do, we will inform you via this website.

Please carefully read the following Privacy Policy of Michelle Valdner, LMHC and all of its subsidiaries, successors in interest, and assigns (collectively, “Michelle Valdner, LMHC”, “us”, “we”) before using: www.LiveHappyCounseling.com all related websites, products, services and related mobile applications (the “Services”), (collectively, the “Site”).  By using the Website you consent to this Privacy Policy. This means that you accept, agree to be bound, and abide by the Privacy Policy. If you do not agree to the Privacy Policy cease use of this Website immediately.  

Your privacy is very important to us. Our Privacy Policy spells out Michelle Valdner, LMHC’s commitment to respecting the privacy of the members and visitors to our Site. We reserve the right to change this policy at any time, which we'll do through online posting or an email message sent directly to you. We are very careful with what we do with your information.

This Privacy Policy governs your access to and use of www.LiveHappyCounseling.com, including any content, functionality and services offered on or through this Website whether as a guest or a registered user. This Privacy Policy also describes how Michelle Valdner, LMHC collects and uses the personal information you provide to us on our Site. It also describes the choices available to you regarding our use of your personal information and how you can access and update this information.

Collection and Use of Personal Information

We collect personal information from you to provide an efficient, meaningful and customized experience for you on the Site. Generally, you control the amount and type of information that you provide to us when using our website.

We collect the following personal information from you:

  • Contact Information such as name, email address, phone number, insurance provider

As is true of most websites, we automatically gather information about your computer such as:

Your IP address, time and date of visit, browser type, referring/exit pages, operating system, agent version, platform, SDK version, timestamp, API key (identifier for application), application version, device identifier, iOS Identifier for Advertising, iOS Identifier for Vendors, Media Access Control (MAC) address, International Mobile Equipment Identity (IMEI), Model, manufacture and OS version of device, session start/stop time, locale (specific location where a given language is spoken), time zone, and network status (WiFi, etc.).

We may log this information for: system administration and improvement, order verification, marketing and system troubleshooting purposes.

We use this information to:

  • Provide our products and services you have requested or purchased from us

  • Send you an email confirmation when you fill out the contact form

  • Personalize and customize our content

  • Send you a newsletter

  • Send you marketing and promotional communications that we believe may be of interest to you

  • Respond to your questions and concerns

  • Improve our website and marketing efforts

  • Conduct research and analysis

  • Display content based upon your interests

  • Contact you with updates to our website, products, and services

 

How Do we Protect Your Information and Secure Information Transmissions?

We employ commercially reasonable methods to ensure the security of the information you provide to us and the information we collect automatically. This includes using standard security protocols and working only with reputable third-party vendors.

Email is not recognized as a secure medium of communication. For this reason, we request that you do not send private information to us by email. However, doing so is allowed, but at your own risk. Some of the information you may enter on our website may be transmitted securely via a secure medium known as Secure Sockets Layer, or SSL.

Information Sharing

We will share your personal information with third parties only in the ways that are described in this privacy statement. We may share personal information with certain third parties in the U.S. that perform services on our behalf. The services provided by those third parties may include: operating the website, hosting the website, providing the products and services you request, authorization and processing of your payments, serving advertisements to you, marketing and promotional material distribution (including direct mail marketing). Those third parties are not authorized to use or disclose personal information you provide to us on or through this website for any purpose other than to perform the services designated by us.

We and our third party service providers in the U.S. may also disclose your personal information:

  • As required or permitted by law such as to comply with a subpoena, in response to a search warrant or other legally valid inquiry, order or similar legal process;

  • To investigate both in the case of a breach of an agreement or contravention of law;

  • When we believe in good faith that disclosure is necessary to protect our rights, protect your safety or the safety of others, establish, exercise or defend a legal claim, investigate fraud or respond to a government request;

  • To any other third party with your prior consent to do so.

If Michelle Valdner, LMHC engages in a joint promotion with an affiliate and/or partner, we may share your contact information with our affiliate and/or partner to be used in relation to the promotion.

We may share non-personal information (such as the number of daily visitors to a particular web page or the size of an order placed on a certain date) with third parties such as advertising partners. This information does not directly identify you or any user by name.

Third Party Websites

Our Site may contain links to third party websites. When you click on a link to any other website or location, you will leave our Site and go to another site, and another entity may collect personal information from you. We have no control over, do not review, and cannot be responsible for, these outside websites or their content. Please be aware that the terms of this Privacy Policy do not apply to these outside websites or content, or to any collection of your personal information after you click on links to such outside websites. We encourage you to read the privacy policies of every website you visit. The links to third party websites or locations are for your convenience and do not signify our endorsement of such third parties or their products, content or websites.

Cookies and Other Tracking Technologies

This Site uses cookies and other tracking. Cookies are small text files of information stored by the Internet browser on your computer's hard drive. For example, we may use cookies to collect browsing data to keep track of your preferences and profile information and to collect general usage and volume statistical information. Our cookies do not collect personal or confidential information and are not spyware. Some of our cookies are served by us, and some are served by third parties who are delivering services on our behalf.

You may set your Internet web browser to refuse cookies or to remove cookies from your hard drive. You can also learn more about cookies by visiting www.allaboutcookies.org which includes additional useful information on cookies and how to block them using different browsers. By blocking or deleting cookies used on our website and mobile application, you may not be able to take full advantage of our services.

The Company reserves the right to use technological equivalents of cookies, including social media pixels. These pixels allow social media sites to track visitors to outside websites so as to tailor advertising messages users see while visiting that social media website. The Company reserves the right to use these pixels in compliance with the policies of the various social media sites.

Children Under the Age of 13

This Site is not intended for children under 13 years of age. No one under age 13 may provide any information to or on the Website. We do not knowingly collect personal information from children under 13. If you are under 13, do not use or provide any information on this Website or on or through any of its features/register on the Website, make any purchases through the Website, use any of the interactive or public comment features of this Website or provide any information about yourself to us, including your name, address, telephone number, email address, or any screen name or user name you may use. 

If we learn we have collected or received personal information from a child under 13 without verification of parental consent, we will delete that information. If you believe we might have any information from or about a child under 13, please contact us at mvaldner@livehappycounseling.com.

Email Policies

We are committed to keeping your e-mail address confidential. We do not sell, rent, or lease our subscription lists to third parties, and will not disclose your email address to any third parties except as allowed in the section titled Information Sharing.

We will maintain the information you send via e-mail in accordance with applicable federal law.

In compliance with the CAN-SPAM Act, all e-mails sent from our organization will clearly state who the e-mail is from and provide clear information on how to contact the sender. In addition, all e-mail messages will also contain concise information on how to remove yourself from our mailing list so that you receive no further e-mail communication from us.

Our emails provide users the opportunity to opt-out of receiving communications from us and our partners by reading the unsubscribe instructions located at the bottom of any e-mail they receive from us at anytime.

Users who no longer wish to receive our newsletter or promotional materials may opt-out of receiving these communications by clicking on the unsubscribe link in the e-mail.

Notification of Privacy Statement Changes

We may update this Privacy Policy to reflect changes to our information practices. If we make any material changes, we will notify you by email (sent to the email address specified in your account) or by means of a notice on this Site prior to the change becoming effective. We encourage you to periodically review this policy for the latest information on our privacy practices.

Non-United States Visitors

If you are a non-U.S. user of the Site, by visiting the Site and providing us with data, you acknowledge and agree that your personal information may be processed for the purposes identified in the Privacy Policy. In addition, your personal information may be processed in the country in which it was collected and in other countries, including the United States where laws regarding processing of personal information may be less stringent than the laws in your country and where your personal information may be accessed by the courts, law enforcement and national security authorities as required under the laws of those jurisdictions. By providing your data, you consent to such transfer.

GDPR

If you are within the European Union, you are entitled to certain information and have certain rights under the General Data Protection Regulation. Those rights include:

  • We will retain the any information you choose to provide to us until the earlier of: (a) you asking us to delete the information, (b) our decision to cease using our existing data providers, or (c) the Company decides that the value in retaining the data is outweighed by the costs of retaining it.

  • You have the right to request access to your data that the Company stores and the rights to either rectify or erase your personal data.

  • You have the right to seek restrictions on the processing of your data.

  • You have the right to object to the processing of your data and the right to the portability of your data.

  • To the extent that you provided consent to the Company’s processing of your personal data, you have the right to withdraw that consent at any time, without affecting the lawfulness of processing based upon consent that occurred prior to your withdrawal of consent.

  • You have the right to lodge a complaint with a supervisory authority that has jurisdiction over issues related to the General Data Protection Regulation.

  • We require only the information that is reasonably required to enter into a contract with you. We will not require you to provide consent for any unnecessary processing as a condition of entering into a contract with us.

For further information on each of these rights (including the circumstances in which they may apply), see the guidance from the UK Information Commissioner's Office (ICO) on individual rights under the General Data Protection Regulation.

We hope that we can resolve any query or concern you raise about our use of your information. The General Data Protection Regulation also gives you right to lodge a complaint with a supervisory authority, in the European Union (or European Economic Area) state where you work, normally live, or where any alleged infringement of data protection laws occurred.

Disclosure of Personal Information We Collect About You

You have the right to know:

·       The categories of personal information we have collected about you;

·       The categories of sources from which the personal information is collected;

·       Our business or commercial purpose for collecting or selling personal information;

·       The categories of third parties with whom we share personal information, if any; and

·       The specific pieces of personal information we have collected about you.

·       Please note that we are not required to:

·       Retain any personal information about you that was collected for a single one-time transaction if, in the ordinary course of business, that information about you is not retained;

·       Reidentify or otherwise link any data that, in the ordinary course of business, is not maintained in a manner that would be considered personal information; or

·       Provide the personal information to you more than twice in a 12-month period.

Personal Information Sold or Used for a Business Purpose

In connection with any personal information we may sell or disclose to a third party for a business purpose, you have the right to know:

·       The categories of personal information about you that we sold and the categories of third parties to whom the personal information was sold; and

·       The categories of personal information that we disclosed about you for a business purpose.

·       You have the right under the California Consumer Privacy Act of 2018 (CCPA) and certain other privacy and data protection laws, as applicable, to opt-out of the sale [or disclosure] of your personal information. If you exercise your right to opt-out of the sale [or disclosure] of your personal information, we will refrain from selling your personal information, unless you subsequently provide express authorization for the sale of your personal information. To opt-out of the sale [or disclosure] of your personal information, visit our homepage and click on the Do Not Sell My Personal Information link here: https://oag.ca.gov/privacy/ccpa.

Right to Deletion

Subject to certain exceptions set out below, on receipt of a verifiable request from you, we will:

·       Delete your personal information from our records; and

·       Direct any service providers to delete your personal information from their records.

·       Please note that we may not delete your personal information if it is necessary to:

·       Complete the transaction for which the personal information was collected, fulfill the terms of a written warranty or product recall conducted in accordance with federal law, provide a good or service requested by you, or reasonably anticipated within the context of our ongoing business relationship with you, or otherwise perform a contract between you and us;

·       Detect security incidents, protect against malicious, deceptive, fraudulent, or illegal activity; or prosecute those responsible for that activity;

·       Debug to identify and repair errors that impair existing intended functionality;

·       Exercise free speech, ensure the right of another consumer to exercise his or her right of free speech, or exercise another right provided for by law;

·       Comply with the California Electronic Communications Privacy Act;

·       Engage in public or peer-reviewed scientific, historical, or statistical research in the public interest that adheres to all other applicable ethics and privacy laws, when our deletion of the information is likely to render impossible or seriously impair the achievement of such research, provided we have obtained your informed consent;

·       Enable solely internal uses that are reasonably aligned with your expectations based on your relationship with us;

·       Comply with an existing legal obligation; or

·       Otherwise use your personal information, internally, in a lawful manner that is compatible with the context in which you provided the information.

Protection Against Discrimination

You have the right to not be discriminated against by us because you exercised any of your rights under the CCPA. This means we cannot, among other things:

·       Deny goods or services to you;

·       Charge different prices or rates for goods or services, including through the use of discounts or other benefits or imposing penalties;

·       Provide a different level or quality of goods or services to you; or

·       Suggest that you will receive a different price or rate for goods or services or a different level or quality of goods or services.

·       *Please note that we may charge a different price or rate or provide a different level or quality of services to you, if that difference is reasonably related to the value provided to our business by your personal information.

Exercising your Privacy Rights & Contact Information

If you would like to exercise any of your rights as described in this Privacy Policy, please:  Write to us at:

Michelle Valdner, LMHC
3650 Long Beach Road #1022 Oceanside, NY 11572

We are not obligated to make a data access or data portability disclosure if we cannot verify that the person making the request is the person about whom we collected information, or is someone authorized to act on such person’s behalf.

Any personal information we collect from you to verify your identity in connection with you request will be used solely for the purposes of verification.

Terms and Conditions of Use

OVERVIEW

Welcome to our website. This website is owned, controlled, and operated by Michelle Valdner, LMHC. The terms “we”, “us”, and “our” refer to www.LiveHappyCounseling.com. The term “Site” refers to www.LiveHappyCounseling.com. The term “user,” “you” and “your” refers to any and all site visitors. The term “Service” refers to general information about services and products, as well as general information about different areas of the law.

This Term of Use Agreement (the "Agreement") specifies the Terms and Conditions for access to and use of the Site (the "Site") and describes the terms and conditions applicable to your access of and use of the Site. This site is maintained as a service to our customers. By using this site, you agree to comply with and be bound by the following terms and conditions of use. Please review these terms and conditions carefully. If you do not agree to these terms and conditions, you should not use this Site. Michelle Valdner, LMHC may amend the Terms of Use at any time. The last update was on December 20, 2020.

PRIVACY

Your visit to our Site is also governed by our Privacy Policy. Please review our Privacy Policy at 1211 Stewart Avenue Ste 100 Bethpage, NY 11714

SITE SUBMISSIONS

The user shall not upload, post or otherwise make available on the site or via email any artwork, photos or other materials (“Materials”) protected by intellectual property laws without the express written permission of the owner of the copyright. You shall be liable for any damage resulting from any infringement of copyrights, trademarks, or other proprietary rights, or any other harm resulting from such a submission. For all Materials submitted by you to the Site, you automatically represent or warrant that you have the authority to use and distribute the Materials, and that the use or display of the Materials will not violate any laws, rules, regulations or rights of third parties.

OWNERSHIP

All content included on this site is and shall continue to be the property of Michelle Valdner, LMHC, its content suppliers and is protected under applicable copyright, patent, trademark, and other proprietary rights. Any copying, redistribution, use or publication by you of any such content or any part of the Site is prohibited, except as expressly permitted in this Agreement. Under no circumstances will you acquire any ownership rights or other interest in any content by or through your use of this Site.

Michelle Valdner, LMHC claims no intellectual property rights over any Materials you supply to the Site. You retain copyright and any other rights you may rightfully hold in any content that you submit through the Site. Content you submit to the Site remains yours to the extent that you have any legal claims. However, you grant Michelle Valdner, LMHC a worldwide, nonexclusive, irrevocable license to display any Materials you supply to us for business development and marketing purposes only. By visiting the site, you agree to hold Michelle Valdner, LMHC harmless from and against all claims, liabilities and expenses arising out of any potential or actual copyright or trademark misappropriation or infringement claimed against you.

If you believe your work has been copied in a way that constitutes copyright infringement, or your intellectual property rights have otherwise been violated, please provide a notice to our office: mvaldner@livehappycounseling.com.

USE OF THIS SITE

To access or use the site, you must be 18 years or older and have the requisite power and authority to enter into these terms and conditions. Children under the age of 18 are prohibited from using this site or service.

Materials on www.LiveHappyCounseling.com contain psychoeducational information and psychotherapy services. Michelle Valdner, LMHC grants you a limited, revocable, nonexclusive license to use this site solely for your own personal use and not for republication, distribution, assignment, sublicense, sale, preparation of derivative works, or other use. You agree not to copy materials on the site, reverse engineer or break into the site, or use materials, products or services in violation of any law. The use of this website is at the discretion of Michelle Valdner, LMHC, and they may terminate your use of this website at any time.

COMPLIANCE WITH LAWS

You agree to comply with all applicable laws regarding your use of the website. You further agreed that information provided by you is truthful and accurate to the best of your knowledge.

INDEMNIFICATION

You agree to indemnify, defend and hold Michelle Valdner, LMHC, and our partners, employees, and affiliates, harmless from any liability, loss, claim and expense, including reasonable attorney's fees, related to your violation of this Agreement or use of the Site.

DISCLAIMER

The information presented on com www.LiveHappyCounseling.com is provided “as is” and “as available,” without representation or warranty of any kind. Michelle Valdner, LMHC does not represent or warrant that such information is or will be always current, complete, or accurate. Michelle Valdner, LMHC disclaims all warranties of any kind, including but not limited to any express warranties, statutory warranties, and any implied warranties of merchantability, fitness for a particular purpose, and non-infringement. To the extent that your jurisdiction does not allow limitations on warranties, this limitation may not apply to you. Your sole and exclusive remedy relating to your use of the Site shall be to discontinue using the Site.

LIMITATION OF LIABILITY

You agree that under no circumstances shall Michelle Valdner, LMHC be liable for direct, indirect, incidental, consequential, special, punitive, exemplary, or any Michelle Valdner, LMHC otheris not liable for damages in connection with (i) any failure of performance, error, omission, denial of service, attack, interruption, deletion, defect, delay in operation or transmission, computer virus or line or system failure; (ii) loss of revenue, anticipated profits, business, savings, goodwill or data; and (iii) third party theft of, destruction of, unauthorized access to, alteration of, or use of your information or property, regardless of our negligence, gross negligence, failure of an essential purpose and whether such liability arises in negligence, contract, tort, or any other theory of legal liability. The foregoing applies even if Michelle Valdner, LMHC has been advised of the possibility of or could have foreseen the damages. In those states that do not allow the exclusion or limitation of liability for the damages, our liability is limited to the fullest possible extent permitted by law.

GUARANTEES

Materials and information provided on the website are not indicative of likely results in any particular fashion. Michelle Valdner, LMHC makes no guarantees as to results; further, past results do not guarantee future results for that same client or party, or any third-party. Michelle Valdner, LMHC make(s) no income/financial claims, nor guarantee of any kind regarding the potential income or results through our communications or your participation in the purchase of any of the products or services on this Site. There is no guarantee you will earn any money using any of our materials, and your revenue is dependent solely on you and your actions or non-actions.

RETURNS/REFUNDS

Unopened, unused items sold by Michelle Valdner, LMHC in new condition may be returned for a full refund within 30 days.  Items that are opened or damaged, or do not have a receipt may be denied a refund or exchange. Your item needs to have the receipt or proof of purchase in order to complete a return.

USE OF INFORMATION

Michelle Valdner, LMHC reserves the right, and you authorize us, to use and assign all information regarding Site uses by you and all information provided by you in any manner consistent with our Privacy Policy.

GOVERNING LAW; VENUE

This Agreement shall be construed in accordance with, and governed by, the laws of New York as applied to contracts that are executed and performed entirely in New York. The exclusive venue for any arbitration or court proceeding based on or arising out of this Agreement shall be Nassau County, New York.

SEVERABILITY

If any term, provision, covenant, or condition of this Agreement is held by an arbitrator or court of competent jurisdiction to be invalid, void, or unenforceable, the rest of the Agreement shall remain in full force and effect and shall in no way be affected, impaired, or invalidated.

ENTIRE AGREEMENT/WAIVER

This Agreement constitutes the entire agreement between you and Michelle Valdner, LMHC pertaining to the Site and Service and supersedes all prior and contemporaneous agreements, representations, and understandings between us pertaining to the Site and Service. No waiver of any of the provisions of this Agreement by Michelle Valdner, LMHC shall be deemed, or shall constitute, a waiver of any other provision, whether or not similar, nor shall any waiver constitute a continuing waiver. No waiver shall be binding unless executed in writing by us.

NOTICES

All notices, requests, demands, and other communications under this Agreement shall be in writing and properly addressed as follows:

Michelle Valdner, LMHC

3650 Long Beach Road #1022 Oceanside, NY 11572

USE OF HEADINGS

The subject headings of the paragraphs and subparagraphs of this Agreement are included for convenience only and shall not affect the construction or interpretation of any of its provisions. 

Good Faith Estimate Notice

Effective January 1, 2022, a ruling went into effect called the “No Surprises Act,” which requires mental health practitioners to provide a “Good Faith Estimate” (GFE) about out-of-network care to any patient who is uninsured or who insured but does not plan to use their insurance benefits to pay for health care items and/ or services

The Good Faith Estimate works to show the cost of items and services that are reasonable expected for your mental health care needs for an item or service.  The estimate is based on information known at the time the estimate was created.  The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment.

You are entitled to receive this “Good Faith Estimate” of what the charges could be for psychotherapy services provided to you. While it is not possible for a psychotherapist to know, in advance, how many psychotherapy sessions may be necessary or appropriate for a given person upon the initiation of psychotherapy, this form provides an estimate of the cost of services provided. Your total cost of services will depend upon the number of psychotherapy sessions you attend, your individual circumstances, and the type and amount of services that are provided to you. This estimate is not a contract and does not obligate you to obtain any services from the provider(s) listed, nor does it include any services rendered to you that are not identified here. 

Good Faith Estimate

This Good Faith Estimate is not intended to serve as a recommendation for treatment or a prediction that you may need to attend a specified number of psychotherapy visits. The number of visits that are appropriate in your case, and the estimated cost for those services, depends on your needs and what you agree to in consultation with your therapist.  You are entitled to disagree with any recommendations made to you concerning your treatment and you may discontinue treatment at any time.

_______________________________________________________________________________

The one-time fee for an initial diagnostic assessment is $150 (CPT Code 90791)

Beyond this, the fee for a traditional 50-minute psychotherapy session (in-person or via telehealth) is $150 (CPT Code 90834/CPT Code 90837).  Most clients will attend one psychotherapy visit per week, but the frequency of psychotherapy visits that are appropriate in your case may be more or less than once per week, depending upon your individual needs and preference.  It is also important, when determining your total estimate, to take into consideration vacations, holidays, emergencies, and sick time.   

You may project any potential future cost(s) by multiplying the session fee of $150 by the total number of sessions.  This will result in your total estimated cost for mental health service(s). 

In example, $150 session fee X 4 sessions =$600.

If you attend therapy for a longer period, your total estimated charges will increase according to the number of visits and length of treatment. 

______________________________________________________________________________ 

Live Happy Counseling recognizes every client’s therapy journey is unique.  How long you need to engage in therapy and how often you attend sessions will be influenced by many factors including:

·       Your schedule and life circumstances

·       Therapist availability

·       Ongoing life challenges

·       The nature of your specific challenges and how you address them

·       Personal finances

You and your therapist will continually assess the appropriate frequency of therapy and will work together to determine when you have met your goals and are ready for discharge and/ or a new “Good Faith Estimate” will be issued should the frequency of session(s) or needs change.  As related, you may request a new GFE at any time in writing during your treatment.  

Good Faith Estimate Disclaimer:

This Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service.  The estimate is based on information known at the time the estimate was created.  Your provider may recommend additional services that are not reflected in this Good Faith Estimate.

The Good Faith Estimate is only an estimate—actual items/ service charges may differ.  The Good Faith Estimate does not include any unknown or unanticipated costs that may arise and are not reasonably expected during treatment due to unforeseen events.  You could be charged more if complications or special circumstances occur.  Other potential items and/ or services associated with therapy charges may include but is not limited to no show/ late cancellation fee(s), record request(s), letter writing(s), legal fee(s)/ court attendance(s), professional collaboration(s), and in-between session supports).  These potential items / services and associated fee(s) are discussed further within the Informed Consent documentation and should these items / services be initiated a new Good Faith Estimate will be provided.  The Good Faith Estimate does not obligate the client to obtain listed items or services.

You have a right to initiate a dispute resolution process if the actual amount charged to you substantially exceeds the estimated charges stated in your Good Faith Estimate (which means $400 or more beyond the estimated charges).

You are encouraged to speak with your provider at any time about any questions you may have regarding your treatment plan, or the information provided to you in this Good Faith Estimate.

For questions or more information related to the Good Faith Estimate, visit www.cms.go/nosurprises or call (800) 368-1019.

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