INFORMED CONSENT FOR IN‐PERSON SERVICES DURING COVID‐19
This document contains important information about our decision (yours and mine) to resume  in‐person services in light of the COVID‐19 public health issue. Please read this carefully and let me know if you have any questions. When you sign this document, it will be an official agreement between us.  

Decision to Meet Face‐to‐Face  

We have agreed to meet in person for some or all future sessions.  If there is a concerning resurgence of the pandemic or if other health concerns arise, however, I may require that we meet via telehealth. If you have concerns about meeting through telehealth, we will talk about it first and try to address any issues. You understand that, if I believe it is necessary, I may determine that we need to return to telehealth.   If you decide at any time that you would feel safer staying with, or returning to, telehealth services, I will respect that decision, as long as it is feasible and clinically appropriate.

Risks of Opting for In‐Person Services  

You understand that by coming to the office, you are assuming the risk of exposure to COVID-19. If you show up for an appointment and I believe that you have a fever or other symptoms or have reason to believe you have been exposed, we will need to end our session and follow up by telehealth as appropriate.  If I, or others sharing this space, test positive  for  the coronavirus, I will notify you so  that you can  take appropriate  precautions.
 
Your Responsibility to Minimize Your Exposure  

To obtain services in person, you agree to take certain precautions which will help minimize risk for others you interact with while here. If you choose to not adhere to these safeguards, it may result in our starting or returning to a telehealth arrangement.  

•You will only keep your in‐person appointment if you are symptom free
•If you have had a direct exposure to someone who tested positive of COVID (including family members, friends, and co-workers), you will immediately let me know and we will then [begin] resume treatment via telehealth.