Peter Bennett LCSW Counseling Services

Consent for Counseling Services

Peter Bennett LCSW LLC

3813 SE Roswell St

Portland, OR 97222

Appointments

Visits are 60 minutes.  As I work out of my home office and do not have a waiting room, I ask that you text me when you arrive and I will meet you at the gate to our backyard.

Fees  $150 per session I accept credit card, cash, check

Fees include post session notes, letters and follow up calls

Insurance:  Aetna, Bridgespan, Medicare, Moda Health, Pacific Source, Regence Blue Cross/Blue Shield.

—Sliding Scale: inquire with me for details

—I have a billing specialist, Shiree Ferguson with Pacific NW Billing Services, who clients may interact with at some point

In case of emergency:

If you are unable to contact me and are having a mental health emergency, you can call the Multnomah County Crisis Line at 503-988-4888 or go to the nearest hospital emergency room.

Cancellations

You must give me at least 24 hours notice of cancellation otherwise you will be charged $50.   To cancel your session please notify me directly by email at peter@peterbennettlcsw.com

Client Rights

—To be treated with dignity and respect.

—To not be denied services on the basis of race, color, creed, gender, sexual orientation, national origin, religion or disability. 

Confidentiality

Records and information about our work will be kept confidential and will be disclosed only as specified by Oregon law:

Under current Oregon law counselors are  required to break confidentiality in these circumstances:

—If someone discloses that s/he has harmed a child or elder through neglect and/or abuse, or that someone s/he knows has done so.  In such a case we are required to notify relevant authorities.

—If there is evidence that a client is in danger of harming his/herself or another person, the law requires counselors to report this to appropriate parties, including possible disclosure to a family member, friend, or police.   

Supervision

Part of my work as a counselor is to seek supervision and discuss the content of sessions with another licensed professional therapist.  I always discuss the content of sessions with the utmost respect for the client and do not disclose any identifying information about those clients who are referenced in this setting.

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