Consent Forms
Consent for Treatment | Capstone Mental Health
Welcome to Capstone Mental Health. We are committed to providing you with compassionate, personalized, and effective mental health care. Before beginning treatment, we require all clients to review and sign a consent form to ensure understanding and agreement regarding your care. Below is an overview of the key elements in our consent form.
Purpose of Consent
The consent form outlines your rights, responsibilities, and the scope of services provided by Capstone Mental Health. By signing this document, you acknowledge your understanding and agreement to participate in treatment under the conditions described.
Key Points of the Consent Form
Nature of Treatment:
Services may include psychiatric evaluations, medication management, therapy, and other related mental health care services.
Treatment plans are individualized based on your unique needs and goals.
Confidentiality:
Your personal information and treatment details are confidential and protected under federal and state laws (e.g., HIPAA).
Exceptions to confidentiality include:
Suspected abuse or neglect of a minor, elder, or vulnerable adult.
Threats of harm to yourself or others.
Court-ordered disclosures.
Telehealth Services:
If you choose telehealth, you consent to receive services through secure video or phone platforms.
You are responsible for ensuring a private, distraction-free environment for your telehealth sessions.
Billing and Insurance:
You agree to provide accurate insurance information and understand your financial responsibilities for co-pays, deductibles, or uncovered services.
Payment is required at the time of service unless prior arrangements have been made.
Cancellation Policy:
We require at least 24 hours' notice for appointment cancellations. Late cancellations or missed appointments may result in a fee.
Medication Management:
Medications may be prescribed as part of your treatment plan. It is your responsibility to take medications as directed and report any side effects or concerns to your provider.
Informed Consent:
You have the right to ask questions, seek clarification, and make decisions about your treatment.
Participation in treatment is voluntary, and you may withdraw consent at any time.
Your Rights as a Client
To receive respectful and professional care.
To be informed about your diagnosis, treatment options, and potential risks or benefits.
To participate actively in the development of your treatment plan.
To request changes to your treatment or seek a second opinion.
How to Provide Consent
Review the consent form carefully.
Discuss any questions or concerns with your provider during your initial appointment.
Sign and date the form to acknowledge your understanding and agreement.
Contact Us
If you have any questions about the consent form or our services, please don’t hesitate to reach out. Our team is here to support you every step of the way.
Thank you for choosing Capstone Mental Health. We look forward to partnering with you on your journey to improved mental health and well-being.