Private Practice Policies

Tracey Middleton, D.PSc, MEd

  • EFT Expert and EFT Universe Certified Trainer
  • Diplomat of Pastoral Science

Confidentiality:

All communication between us is confidential and will not be divulged to anyone without your permission.  The only exceptions to this rule are the following situations in which I am a mandated reporter:

  1. If you become dangerous to yourself, I will take action to protect you which may include talking with family members and/or seeking hospitalization.
  2. If you become dangerous to another person, I will take action to protect both you and the other person which may include informing the other person of the danger and informing the police.
  3. Physical or sexual abuse of a minor, an elderly person, or a handicapped person is mandated to be reported to DSS, whether you are the person victimized or whether you are an adult involved in the abuse of a person in any of these categories.
  4. In certain court cases involving custody of minors, a judge’s order could require my records and testimony in court.
  5. My social work license requires me to get periodic supervision, and my supervisor is under the same rules of confidentiality that I am.
  6. I may disclose your health information to authorized federal officials who are conducting national security and intelligence activities or providing protective services to the President or other important officials. By law I cannot reveal when I have disclosed such information to the government. (Patriot Act, passed October, 2001)

Appointments:

All telephone or SKYPE sessions are by appointment, scheduled directly with me.  If I am unavailable when you call, please leave your name and phone number on my answering machine.

My SKYPE address is tappingforpeace

If you can call me at no extra charge to you, then please call me at our appointed time at 443-805-6119.  If you have to pay extra to call me, then I can call you instead, as I have a package long-distance plan.  Please let me know what number to reach you at, and please be available at our scheduled time as you use up your own time if you are late.

Cancellations:

Please call to inform me if you must cancel.  If I am unavailable, please leave a message on my answering machine.

Except for genuine emergencies, if you cancel your appointment with less than 24 hours notice or do not show up for your scheduled visit, you will be charged for the time I have set aside for you.

Fees:

Please contact Tracey for her hourly rates. Often telephone sessions need longer than an hour to complete and the average session is an hour and a half. Know that you are in charge of deciding how long you would like the session to last. If you need extra time and my schedule allows, you may increase your time at the regular hourly rate or shorten it.

If you are unable to afford the usual fee, please feel free to discuss a sliding scale fee.

My policy is that there is no charge for a 15-minute telephone call, but longer time is charged at the usual hourly rate.

FEE FOR A FAILED APPOINTMENT:  $40.00

Email:

Feel free to contact me via email to schedule appointments.  If you need to cancel an appointment, please call me on the telephone, as I may not have checked my email recently.  Please keep email communication brief, as I do not do therapy via email, but at times am able to offer tapping suggestions when appropriate.  Also, please do not send me any forwarded messages or chain emails.  My email address is mailto:tracey_middleton [@] verizon [.] net.

Billing:

All session charges are due and payable at the end of each office visit.  You can send a check for whatever amount of time we worked to me through the mail. I will give the address at a later date.

PLEASE CLICK THIS LINK TO DOWNLOAD A PAPER VERSION OF THE PRIVATE PRACTICES POLICIES AND SIGN THE AGREEMENT FORM TO INDICATE: I have read the preceding statements of policies around the way we agree to work together and have discussed any questions I have about them.

OR, USE THE FORM BELOW TO DIGITALLY SIGN THE PRIVATE PRACTICES FORM TO INDICATE: I have read the preceding statements of policies around the way we agree to work together and have discussed any questions I have about them:Form Manager: shortcode must include a form slug. For example, something like '[form form-1]'

BY FILLING IN AND SUBMITTING THE FORM BELOW, YOU ARE DIGITALLY SIGNING THIS HIPPA FORM

Upon submitting this form, please email Tracey directly to alert her to your form submission: tracey_middleton@verizon.net

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  • , have received a copy of and understand this Notice of Private Practice Policies.