Informed consent and Terms of Service for Therapy Service – Tele-Health

*Signed consent is required
CONSENT FOR COUNSELING
You are consenting to counseling services with Tina C. Christian, LPC, an independently practicing licensed professional counselor. Completely independent in providing you with clinical services, Tina C. Christian, LPC, alone is fully responsible for those services. Professional records are separately maintained and no one else can have access to them without your specific, written permission.
The consenting client consents to, and authorizes services, by Tina C. Christian, LPC. These services may include psychotherapy, therapy, diagnostic procedures, coaching and other appropriate alternative therapies.
Click here  to read counseling TOS,  download and or print a copy of these terms of service for treatment.  
 

 

Informed consent and Terms of Service for Coaching Service

 
*Signed consent is required

CONSENT FOR COACHING

You are consenting to coaching services with Tina C. Christian, LPC, an independently practicing licensed professional counselor. Completely independent in providing you with coaching services, Tina C. Christian, LPC, alone is fully responsible for those services. Professional records are separately maintained and no one else can have access to them without your specific, written permission.
The consenting client consents to, and authorizes services, by Tina C. Christian, LPC. These services may include coaching note, session procedure and other appropriate interactions.
Click here to read Coaching TOS, download and or print a copy of these terms of service for coaching. 
 
HIPAA FACT SHEETS

Your Health Information Privacy Rights

Privacy, Security, and Electronic Health Records

Sharing Health Information with Family Members and Friends

For more information on HIPAA, including the fact sheets listed above, and who does and who does not have to follow these laws, please visit the U.S. Department of Health and Human Services website by clicking here

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