Client Rights

The USA Psychology Clinic values and strives to respect each individual patient/client and supports the following rights:

• The right to receive services regardless of race, sex, ethnic background, religion, physical / mental disabilities, or sexual orientation.
• The right to considerate and respectful care.
• The right to receive evaluation and treatment based on your needs and goals.
• The right to ask for and receive relevant, current, and understandable information concerning your diagnosis and/or presenting problems.
• The right to expect all communications and records pertaining to treatment be treated confidential, except as required by law.
• The right to be fully informed regarding evaluation and/or treatment services, and to the terms under which services will be provided.
• The right to refuse evaluation or treatment of any kind unless law limits the right of refusal.
• The right to be informed of treatment alternatives when services at the USA Psychology Clinic are not appropriate or feasible.

Confidentiality Statement

All psychological information is handled in a professional manner in accordance with guidelines of the American Psychological Association. Your records will not be sent to others without a signed release from you. If you have any questions about our privacy practices and/or questions about your confidentiality, you should ask your therapist or direct your question/concern to the USA Psychology Clinic Director, Dr. Kimberly Zlomke.

Good Faith Estimate (GFE) Notice

As part of the No Surprises Act, the USA Psychological Clinic is required to provide a Good Faith Estimate (GFE) of the cost of services with us. This law makes sure that consumers are aware of fees and that there are no surprises when billed for services. Under the law, health care providers are required to give clients who do not have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services.

The standard fees for the Psychological Clinic are listed on our website.

• You have the right to receive a Good Faith Estimate (GFE) for the total expected cost of any non-emergency healthcare services, including psychotherapy services.
• You can ask your healthcare provider, and any other provider, for a Good Faith Estimate before you schedule a service, or at any time during treatment.
• The Good Faith Estimate will be discussed with you via phone at the time that you schedule your intake appointment and you will receive a copy at your initial appointment.
• If you request, you will be provided with a mailed copy of your Good Faith Estimate prior to scheduling an intake appointment.
• If you receive a bill $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate.
• For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059

Fee Chart