I understand that these consultations do not constitute clinical supervision and that I remain
completely responsible – ethically and legally – for the decisions I make in my own clinical case
situations. My consultant will provide me with an opportunity to discuss clinical cases and issues
about which she may have some expertise, and she may help me consider options for responding,

but the comments made for my consideration are not supervisional mandates. If she does not
have an answer to a question or issue brought up in consultation, she will: find out this
information and convey it to me; and/or will provide help in connecting with a consultant who is
more knowledgeable on that topic.

I also understand that although we may sometimes need to discuss personal issues that may be
relevant to my clinical work, these consultation services do not constitute psychotherapy.
I understand the potential limits of the confidentiality of this relationship. To the extent possible,
my case presentations will provide no identifiable patient information. However, I understand
that if I provide identifiable information about a situation regarding which my consultant has an
ethical or legal obligation to report confidential information, she will inform me at the time and
will give me the opportunity to make the report myself.

I understand that if my consultant becomes aware that she knows or has a prior relationship with the presented client(s), or if she believes she has a potential conflict of interest in her relationship with me, she will notify me of that fact immediately and will cooperate in helping me find a different consultant.

I agree to the fee of $45 per one-hour individual consultation session; $45 per two hour group
consultation and/or $25 per one hour group consultation, payable at each meeting.   Payment is due at the time of the group via Venmo @Paula-Pow-Soto (last 4 digits of cell 9553; friends/family preferred - not goods/services please.)  Please contact Paula if you need a different payment option. 

I agree to the cancellation policy of 24 hours’ notice per cancellation.

Any missed appointment without 24 hours’ notice will be charged full fee.:

Rates
$45 Individual hour
$45 Group 2 hour (up to 8 people)
$25 Group 1 hour (up to 4 people)

Exceptions:
I am unable to waive fee when your missed appointment is due to work or childcare issues. I am able to waive this fee on a limited case by case basis, with documentation of an emergency or other extenuating situation. 

If you have an unusual number of cancelled sessions (with or without 24 hours notice) and we are unable to address and resolve your challenges to attending your scheduled appointments, I will need to decline further requests for consultation.