Agreements between the provider and client make our relationship more professional and clarified.
Please fill out the on line form & let us know how we can help you!
The provider will complete this form and send it to the client or the representative to sign before services are rendered
The following terms apply to home or facility visits in addition to the above terms:
PAYMENT
Payment is expected at the time of the session. We accept cash, checks, Zelle, and PayPal. The client or representative will pay any fees for insufficient funds checks or service charges by other payment methods. The client will be charged for a full session if s/he decides to end the session early.
PACKAGES AND PREPAID SESSIONS
MUST BE USED WITHIN 1 YEAR OF PURCHASE
The client may gift the sessions to another person.
The client is responsible for keeping track of the used and remaining sessions in a package.
The client is responsible for keeping tack of prepaid sessions.
INSURANCE: Through Headway.co, we may accept Cigna for music therapy services for clients who live in New York State only. Otherwise, our services are private pay.
LATENESS/CANCELLATION/RESCHEDULING POLICY/CLIENT'S RESPONSIBILITIES TO BE PREPARED
An appointment is a commitment of time and money; it was set aside for the client and could have been used for another client to get help and to avoid a loss of income for the practitioner. So, we ask you to be prepared, mindful and responsible.
The client or representative is responsible for payment if s/he cancels within 48 hours or less of the scheduled session time and it cannot be rescheduled within the same week.
The client will be ready for services when the provider arrives or calls or signs on to Zoom or any other venue for providing services. If the client is not ready within a reasonable amount of time (i.e., 5-10 minutes), the provider will count the waiting time as part of the session time.
In case of inclement weather, public health emergency or unforeseen events such as medical or family emergency or truly not feeling well, the client and provider will make an effort to reschedule the session(s) in the same week or a reasonable amount of time shortly afterwards (e.g., 1 week).
Clients are requested to have ready the issue(s) they want to address. If the client is unprepared for a session and cannot figure out what is their issue within a reasonable amount of time (e.g., 5-15 minutes of the start time), s/he will pay for the session as a discovery/consultation session of what the client needs or be charged additional fees to complete the session if a) the practitioner is available to provide more time than a usual session time and b) the client wants to complete the session at that time.
A discovery session will be counted as a single session or one that's part of a package at the same rate.
In accordance with HIPAA regulations, we use HIPAA-compliant ZoomPro for remote sessions. If the client does not have access to Zoom, we may use the phone in an area that is private or as private as possible for remote sessions and cannot guarantee HIPAA compliance.
Please also note the following viz. HIPAA compliance:
1) The provider is not required to disclose any personal health information such as vaccine status, health conditions, and the like. (The provider ensures that she is in good health to the best of her knowledge.)
2) The provider, however, may ask for the patient's diagnosis or diagnoses and other physical and mental health history in order to provide appropriate interventions and services
3) We may ask for this information also in order to obtain payment for services from insurance or other venue which is allowable by law
4) Except if the client is in danger of harming him/herself or someone else, G-d forbid, we do not discuss patient information with anyone unless we have obtained verbal or written permission of the client or authorized persons such as the legal representative, health care proxy, and the like. If the client is in danger of harming him/herself or the clinician, we will contact EMS and/or other providers to ensure safety for all and will need to disclose the client's identifying information
5) We cannot guarantee confidentiality in transmitting unencrypted texts, emails, or other electronic venues, so we advise clients not to communicate anything of a sensitive nature electronically.
6) The provider does use screen savers for confidentiality.
1. The provider may communicate by unencrypted email, text, and leave voice messages and make an effort to leave the least amount of personal information.
2. The provider does not use electronics nor conduct business on the Sabbath (Friday afternoons through Saturday sunset) and requests that clients call Monday-Friday.
3. The provider requests that clients call Monday-Thursday between 9:30 a.m.-7 p.m. and Friday 9:30-1 EST.
4. In case of a true emergency, please call 911 or 988.
5. Clients are requested to make their messages as brief as possible.
6. In accordance with NYS practice guidelines, the provider does not engage socially with clients on social media.
Music therapy, energy healing and balancing, The Emotion Code, The Body Code and any other services provided by healingnotes.com/Shoshana Averbach may remove or reduce energetic vibrations of traumas, trapped emotions, blockages, negative energies, and imbalances to promote healing for physical and emotional maladies. Muscle testing and intuitive inquiry may check what the subconscious mind and/or spirit reveals (i.e., the need for a certain food or nutrient), and these are intended as suggestions only. The suggestions are based on what the subconscious mind or spirit communicates by using muscle testing and, in some cases, intuitive inquiry, and the suggestions are not intended to be given as professional advice. Clients consent to muscle checking and intuitive inquiry as part of the session.
Clients understand that uncomfortable feelings and past recollections may arise as part of the session for the purposes of clearing the imbalances and maladies. Resolution or amelioration of symptoms is not guaranteed and clients should seek further assistance with their medical/mental-health providers. The practitioner is not held liable for preexisting conditions getting worse while practicing in good faith.
The client is responsible for following up about those suggestions with a professional. Sessions may also complement treatment for physical and mental health conditions that are provided by another licensed medical or mental health provider, nutritionist, etc. HOWEVER, they are not intended as a form of diagnosis and treatment nor cure that a licensed medical or mental health professional would provide and is NOT a substitute for medical care, nutritional advice, nor mental-health services and anything that is outside the scope of practice of HealingNotes/Shoshana Averbach as a social worker, music therapist, case manager, practitioner of the Body/Emotion Code, etc.
Any suggestions that are given are for that particular modality (e.g., The Emotion Code) and are not a part of any other professional license held by the practitioner. (Example: Body Code sessions are separate from the practitioner's other credentials and professional licenses unless the practitioner is using the Body Code as a treatment modality while providing and billing services as a social worker within her scope of practice.)
NOTE: Our services may complement treatment for medical and emotional issues and are not a substitute nor are intended to diagnose any medical and psychological conditions nor offer any substitute for treatment.
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