A Psych Guy PLLC
800 NE 62nd Street, Suite 407, Fort Lauderdale, FL (860) 944-5114
Services Provided
I am a licensed physician in the state of Florida. I am a board-eligible psychiatrist and provide psychotherapy and medication management to adults. After our initial visit, we will discuss treatment options and recommendations. Together, we will decide on the best course of care for you. Psychiatric treatment is a partnership and requires active participation from both of us. Either of us can choose to discontinue the partnership at any time for any reason.
To better involve you in your care, please make sure that I always have updated contact information for you.
Confidentiality
No photography or audio recording is permitted in sessions.
All information is strictly confidential with the following exceptions:
• When you give me written permission to release the information to someone.
• When legal and ethical responsibilities require me to disclose information for safety reasons, such as instances of a patient threatening harm to self or others.
• When ordered or subpoenaed by court.
• By law, I must report abuse of children or mentally disabled/vulnerable adults to Child or Adult Protective Services.
• When it is necessary to obtain payment that is due.
• If you are applying for reimbursement from your health insurance, I may be required to provide your health plan some or all of your records. By signing this form, you consent to release that information to your health insurance plan. Please see the HIPAA Notice of Privacy Practices for further information.
Insurance
I am an “out of network” provider for all other insurance plans including Medicare and Medicaid. Full payment is due at the time of each visit, and I will provide you with an electronic receipt. You can submit this receipt to your insurance company for reimbursement directly to you at “out of network” rates.
If you are planning to seek reimbursement, I encourage you to contact your insurance carrier to find out about your “out of network” benefit so that you can anticipate your out-of-pocket expenses prior to scheduling an appointment.
Medical Health, Pregnancy, and Medication
Please alert me to any changes in your medical health or when you start any new medications, including over the counter medications, supplements, or herbal remedies.
Some psychiatric medications can pose a hazard to a pregnant woman’s fetus. If you are considering becoming pregnant or suspect that you might be pregnant, please discuss this with me as soon as possible so that we can discuss the risks and benefits of continuing your medication during pregnancy.
In most circumstances a recent physical is required before psychiatric medication is prescribed. It is expected that every patient has established care with a primary care provider (a family physician or internist) before they see a specialist such as myself.
If you have had previous mental health providers, I may find necessary request to communicate with them or obtain records before we begin treatment.
If you are currently in treatment with another psychiatrist (or psychiatric nurse practitioner) and are seeking a second opinion, I welcome such consultation, but also request to have an opportunity to communicate with the current provider.
If you are transferring care to me from another provider, please understand that I may not agree with their treatment plan and may not be able to automatically renew the medications you have been receiving. I will however review your past records and history and we will work on the most appropriate treatment plan together. When transferring any care to me, prior records are always required before an intake appointment is scheduled.
Should you be hospitalized at any time, I anticipate that the inpatient physician coordinate care with me. If that is not done, I may not be able to continue medications that were prescribed in the hospital if I find the treatment plan to be unwarranted or potentially harmful.
Fees and Payment
The fee for the first new patient visit is $500. The visit lasts 90 minutes.
The fees for return visits vary depending on the length of the visit and type of care provided (medications, therapy, or both) is $200.
Payment is due at each visit. I accept cash, debit card and credit cards. I require each patient to have a valid credit card on file to charge for any outstanding balances. Please see credit card authorization form for further information.
A fee of $50 is assessed for any medication prior authorization that requires more than 15 minutes of my time.
If paperwork is required for any reason you should schedule an appointment and have it completed in session. If you ask me to complete paperwork or write a letter outside of a session a $100 fee will be assessed.
The fee for chart notes/medical records is $0.25 per page.
Cancellations and Missed Appointments
Your appointment is reserved exclusively for you, so please give at least 48 business hours notice for any appointment which you are unable to keep. Full fees are charged for missed appointments and cancellations with less than 48 business hours notice. Please note that insurance does not reimburse any portion of these missed appointment fees.
Missing appointments interferes with the efficacy and continuity of your care. A pattern of repeatedly missing appointments is grounds for termination of care.
Prescriptions
I will write prescription refills during our visits. I will give you enough refills until your next appointment. Please make sure that you have an appointment scheduled before you run out of refills. In the rare occurrence that you need a refill between visits, please have your pharmacy call or email me directly. It can take up to 48 business hours to fill a refill request.
For most medications, I will send an electronic prescription to your pharmacy.
Contact Outside of Appointments
Although I generally make myself available to patients and encourage contact with any questions or concerns, I may not be available for your needs 24/7. You may contact me by calling. I will do my best to respond within one business day. As a solo physician, I do not have Sunday or evening coverage.
Due to my lack of office staff, I expect that a message through call will be the usual mode of communication for non-urgent matters between appointments. If you ask more detailed clinical questions by portal message, I will likely ask you to schedule an appointment. Also keep in mind that any communication will become part of the medical record.
For matters that can’t wait for my return call, you can always call the 24 hour Crisis Line at 211 or (954) 537-0211. In the event of a psychiatric or medical emergency, please call 911 or go to the nearest emergency department.
Clients’ Rights
You have the right to be an active participant in decisions regarding your evaluation and treatment. You have the right to refuse evaluation or treatment, the right to choose the mental health provider and practice modality that best suits your needs, and the right to receive a referral from me to another mental health provider. You have the right to contact the Florida Department of Health.
Authorization
By checking box, I agree that I have read and agree to the policies listed above. I acknowledge that I am responsible for all balances on my account. I also acknowledge that I received or declined a copy of the HIPAA Notice of Privacy Practices (separate). I voluntarily consent to treatment and understand that informed consent ends with the termination of the professional relationship, which I may terminate at any time.
A Psych Guy PLLC values its users’ privacy. This Privacy Policy (“Policy”) will help you understand how we collect and use personal information from those who visit our website or make use of our online facilities and services, and what we will and will not do with the information we collect. Our Policy has been designed and created to ensure those affiliated with A Psych Guy PLLC of our commitment and realization of our obligation not only to meet, but to exceed, most existing privacy standards. We reserve the right to make changes to this Policy at any given time. If you want to make sure that you are up to date with the latest changes, we advise you to frequently visit this page. If at any point in time A Psych Guy PLLC decides to make use of any personally identifiable information on file, in a manner vastly different from that which was stated when this information was initially collected, the user or users shall be promptly notified by email. Users at that time shall have the option as to whether to permit the use of their information in this separate manner. This Policy applies to A Psych Guy PLLC, and it governs any and all data collection and usage by us. Through the use of www.apsychguy.com, you are therefore consenting to the data collection procedures expressed in this Policy. Please note that this Policy does not govern the collection and use of information by companies that A Psych Guy PLLC does not control, nor by individuals not employed or managed by us. If you visit a website that we mention or link to, be sure to review its privacy policy before providing the site with information. It is highly recommended and suggested that you review the privacy policies and statements of any website you choose to use or frequent to better understand the way in which websites garner, make use of and share the information collected. Specifically, this Policy will inform you of the following What personally identifiable information is collected from you through our website; Why we collect personally identifiable information and the legal basis for such collection; How we use the collected information and with whom it may be shared; What choices are available to you regarding the use of your data; and The security procedures in place to protect the misuse of your information.Privacy Policy
It is always up to you whether to disclose personally identifiable information to us, although if you elect not to do so, we reserve the right not to register you as a user or provide you with any products or services. This website collects various types of information, such as:
· Information automatically collected when visiting our website, which may include cookies, third party tracking technologies and server logs.
In addition, A Psych Guy PLLC may have the occasion to collect non-personal anonymous demographic information, such as age, gender, household income, political affiliation, race and religion, as well as the type of browser you are using, IP address, or type of operating system, which will assist us in providing and maintaining superior quality service.
A Psych Guy PLLC may also deem it necessary, from time to time, to follow websites that our users may frequent to gleam what types of services and products may be the most popular to customers or the general public.
We are collecting your data for several reasons:
The data we collect from you will be stored for no longer than necessary. The length of time we retain said information will be determined based upon the following criteria: the length of time your personal information remains relevant; the length of time it is reasonable to keep records to demonstrate that we have fulfilled our duties and obligations; any limitation periods within which claims might be made; any retention periods prescribed by law or recommended by regulators, professional bodies or associations; the type of contract we have with you, the existence of your consent, and our legitimate interest in keeping such information as stated in this Policy.
A Psych Guy PLLC does not now, nor will it in the future, sell, rent or lease any of its customer lists and/or names to any third parties.
A Psych Guy PLLC may collect and may make use of personal information to assist in the operation of our website and to ensure delivery of the services you need and request. At times, we may find it necessary to use personally identifiable information as a means to keep you informed of other possible products and/or services that may be available to you from www.apsychguy.com
A Psych Guy PLLC may also be in contact with you with regards to completing surveys and/or research questionnaires related to your opinion of current or potential future services that may be offered.
A Psych Guy PLLC may not use or disclose the information provided by you except under the following circumstances:
A Psych Guy PLLC greatly respects your privacy. We do maintain and reserve the right to contact you if needed for non-marketing purposes (such as bug alerts, security breaches, account issues, and/or changes in A Psych Guy PLLC products and services). In certain circumstances, we may use our website, newspapers, or other public means to post a notice.
A Psych Guy PLLC’s website is not directed to, and does not knowingly collect personal identifiable information from, children under the age of thirteen (13). If it is determined that such information has been inadvertently collected on anyone under the age of thirteen (13), we shall immediately take the necessary steps to ensure that such information is deleted from our system’s database, or in the alternative, that verifiable parental consent is obtained for the use and storage of such information. Anyone under the age of thirteen (13) must seek and obtain parent or guardian permission to use this website.
All users and visitors to our website have the option to discontinue receiving communications from us by way of email or newsletters. To discontinue or unsubscribe from our website please send an email that you wish to unsubscribe to hello@apsychguy.com. If you wish to unsubscribe or opt-out from any third- party websites, you must go to that specific website to unsubscribe or opt-out. A Psych Guy PLLC will continue to adhere to this Policy with respect to any personal information previously collected.
Our website does contain links to affiliate and other websites. A Psych Guy PLLC does not claim nor accept responsibility for any privacy policies, practices and/or procedures of other such websites. Therefore, we encourage all users and visitors to be aware when they leave our website and to read the privacy statements of every website that collects personally identifiable information. This Privacy Policy Agreement applies only and solely to the information collected by our website.
A Psych Guy PLLC’s operations are located primarily in the United States. If you provide information to us, the information will be transferred out of the European Union (EU) and sent to the United States. (The adequacy decision on the EU-US Privacy became operational on August 1, 2016. This framework protects the fundamental rights of anyone in the EU whose personal data is transferred to the United States for commercial purposes. It allows the free transfer of data to companies that are certified in the US under the Privacy Shield.) By providing personal information to us, you are consenting to its storage and use as described in this Policy.
A Psych Guy PLLC takes precautions to protect your information. When you submit sensitive information via the website, your information is protected both online and offline. Wherever we collect sensitive information (e.g. credit card information), that information is encrypted and transmitted to us in a secure way. You can verify this by looking for a lock icon in the address bar and looking for “https” at the beginning of the address of the webpage.
While we use encryption to protect sensitive information transmitted online, we also protect your information offline. Only employees who need the information to perform a specific job (for example, billing or customer service) are granted access to personally identifiable information. The computers and servers in which we store personally identifiable information are kept in a secure environment. This is all done to prevent any loss, misuse, unauthorized access, disclosure or modification of the user’s personal information under our control.
The company also uses Secure Socket Layer (SSL) for authentication and private communications to build users’ trust and confidence in the internet and website use by providing simple and secure access and communication of credit card and personal information.
By using this website, you are hereby accepting the terms and conditions stipulated within the Privacy Policy Agreement. If you are not in agreement with our terms and conditions, then you should refrain from further use of our sites. In addition, your continued use of our website following the posting of any updates or changes to our terms and conditions shall mean that you agree and acceptance of such changes.
If you have any questions or concerns regarding the Privacy Policy Agreement related to our website, please feel free to contact us at the following email, telephone number or mailing address.
Email Address: hello@apsychguy.com
Mailing Address: psyKiatry PLLC, 800 NE 62nd St, Suite 400, Fort Lauderdale, Florida 33334