Telehealth/Distance Professional Service Policies

1. Telehealth therapy falls into the broad category of Distance Professional Services as this type of service can be accomplished through different technologies (i.e., Video teleconferencing, Telephonic, Chat or email. 
2. Clients need to understand concerns associated with these service modes and have the right to ask questions about these modalities and to be provided answers in a language they understand  
3. Distance services are not the same as face-to-face meetings; most noticeable is diminished therapist support not being physically located with the client.
4. A client must identify an emergency contact for each session, and must allow the therapist to notify that contact should concerns for the client’s safety arise
5. Clients must be physically present in Arizona to participate in distance services requiring the client to confirm their address or location at the session’s start 
6. Distances services provide increased care access and meeting convenience however, they also create potential challenges to confidentiality which must be regularly addressed
7. LLCS therapists must ensure that the client’s confidentiality is protected and will need to disconnect from the session to prevent breech of client’s confidentiality
8. Possible interruption, unauthorized access, and technical difficulties are risks inherent in distance services.  The therapist or client can discontinue a visit if feels the distance service connection is not adequate for the situation.  
9. Transition to in-person therapy may be necessary for reasons concerning the therapist or client.  Reasons include technological limitations, non-securable confidentiality and symptom or developmental appropriateness, 
10. A referral to another therapist may be needed if distance services are deemed inappropriate and travel and scheduling may limit in-person services
11. The provider will provide directions for session connection through a HIPAA-compliant communication services before the session  
12. If technical issues arise the provider will have access to a secondary HIPAA-compliant telehealth platform or complete the session
13. Clients do not have the right to willfully change or terminate aspects of the services platform (i.e., video, if video teleconferencing is the selected platform)
14. Recording of distance service sessions is forbidden without the express written consent of either the therapist or the client
15. The therapist is not responsible for confidentiality breaches resulting by direct client actions, failure to maintain their equipment’s security software or by technological actions beyond the warranties of the platform provider
16. Distance services do not negate laws governing appropriate behavior; threats and gestures of violence and lewd conduct may result in legal prosecution
17. Termination of distance services due to technological difficulties or confidentiality concerns is not automatic grounds for a waiving of service fees.  Prior discussion of concerns involving participation concerns, missed, or prematurely terminated sessions or willful termination of video feeds, communicated to the client by the therapist will be taken into fee consideration.   
18. By completing the LLCS registration, the client certifies: 
1. Having read or had this form read and/or had this form explained to them,
2. That they fully understand its contents including the risks and benefits of distance therapy services.
3. That they have been given ample opportunity to ask questions and that any questions have been answered to their satisfaction