Informed Consent & Agreement for Psychotherapy Services Updated 10/01/26
ENCOMPASS COUNSELING
PRACTICE POLICIES & INFORMED CONSENT
KayLynn Aragon, MA, LMHC
7620 Jefferson St NE, Unit 7
Albuquerque, NM 87109
Phone: 505-456-2253
Email: Info@EncompassCounseling.net
ABOUT THESE POLICIES
This document outlines the practice policies and informed-consent information for psychotherapy services provided through Encompass Counseling.
Please read these policies carefully. They are intended to help clarify expectations regarding appointments, communication, telehealth, social media, treatment, payment, and ending therapy.
Your separate Notice of Privacy Practices explains your rights regarding your protected health information and how Encompass Counseling may use and disclose that information.
If you have questions about any of these policies or your treatment, please discuss them with your therapist.
THE THERAPY RELATIONSHIP
Psychotherapy is a collaborative process. Treatment will be guided by your concerns, goals, needs, preferences, and circumstances.
There is no guarantee that therapy will produce a particular outcome. Your therapist will work with you to evaluate your progress and determine whether the treatment approach continues to meet your needs.
Your therapist may draw from integrative, trauma-informed, attachment-based, experiential, somatic parts-based work, mindfulness-based, and other approaches as clinically appropriate.
Treatment may include individual or couples psychotherapy, including EMDR when clinically appropriate.
You are encouraged to ask questions about your treatment, participate in decisions about your care, and communicate concerns about the therapeutic process.
APPOINTMENTS AND CANCELLATIONS
Standard psychotherapy appointments are 55 minutes.
If you would like to change the length or frequency of your sessions, please discuss this with your therapist so that an appropriate appointment can be scheduled.
Cancellations and Rescheduling
Please cancel or reschedule appointments at least 48 hours in advance.
Appointments cancelled or rescheduled with less than 48 hours' notice are subject to the full session fee.
Late Arrival
If you arrive late for an appointment, the session will generally end at the originally scheduled time. The missed portion of the appointment may not be added to the end of the session.
Cancellation Allowance
For clients scheduled weekly:
Up to 6 cancellations per calendar year may be made without a cancellation fee when at least 48 hours' notice is provided.
These cancellations are divided into three semesters, with up to 2 cancellations permitted per semester.
For clients scheduled every other week:
Up to 1 cancellation per semester, or 3 cancellations per calendar year, may be made without a cancellation fee when at least 48 hours' notice is provided.
Additional cancellations will be subject to the full session fee according to the practice cancellation policy.
FEES AND PAYMENT
Encompass Counseling is a self-pay practice.
Current Fees
Individual Therapy: $130 / 55-minute session
Couples Therapy: $160 / 55-minute session
Payment is due at the time of service.
Encompass Counseling does not bill insurance companies directly.
Some clients may have out-of-network insurance benefits that reimburse a portion of the cost of therapy. Eligibility, reimbursement amounts, deductibles, and coverage are determined by your insurance plan, not by Encompass Counseling.
You are responsible for understanding your insurance benefits and for any portion of the fee that is not reimbursed.
You may submit a superbill to your insurance company yourself or choose to use a third-party service, such as Thrizer, to assist with out-of-network reimbursement.
Returned Payments
A $10 returned-check special handling fee may be charged when a payment is returned.
ELECTRONIC HEALTH RECORD AND CLIENT PORTAL
Encompass Counseling uses SimplePractice as its electronic health record and client-management platform.
The SimplePractice Client Portal may be used for intake paperwork, documents, appointment requests, billing, and other practice functions.
Encompass Counseling also uses SimplePractice Secure Messaging for secure electronic communication with clients. SimplePractice describes Secure Messaging as a HIPAA-compliant communication method.
Clients are responsible for taking reasonable precautions to protect access to their Client Portal, including using care when accessing the portal from shared or public devices.
COMMUNICATION
Secure Messaging
The SimplePractice Client Portal and Secure Messaging are the preferred methods for communicating about information that may be confidential or related to your care.
Secure Messaging is intended for communication between sessions and administrative or clinically appropriate communication. It is not a substitute for psychotherapy sessions and is not monitored continuously.
Your therapist may not be immediately available to respond to messages.
SimplePractice may send an email notification when a new Secure Message is available. The notification is not intended to contain the substance of the clinical communication.
Email and Text Messaging
Email and text messaging may be used for limited administrative communication, such as scheduling, appointment changes, or cancellations.
Because standard email and text messaging may carry privacy and security risks, please do not use them for detailed clinical information, requests for clinical assistance, or emergency communication.
Your therapist will make reasonable efforts to respond to electronic messages in a timely manner, but immediate responses cannot be guaranteed.
Telephone
If you need to contact the practice by telephone, please leave a voicemail when your therapist is unavailable.
Your therapist will generally attempt to return calls within 24 hours during normal practice periods, but immediate responses cannot be guaranteed.
TELEHEALTH
Telehealth may be used when clinically appropriate and available.
Telehealth may include psychotherapy provided through secure video or other electronic means.
Potential Benefits
Telehealth may provide:
Greater access to therapy
Convenience and flexibility
Reduced travel
Reduced time away from work or other responsibilities
Continuity of care when attending in person is difficult
Access to therapy when distance, illness, travel, or other circumstances make an in-person appointment impractical
Potential Risks and Limitations
Telehealth has potential risks and limitations, including:
Technology may fail, become interrupted, or prevent a session from occurring.
The therapist may have less ability to observe physical presentation, movement, facial expressions, body language, or other nonverbal information.
Clinically relevant information may be less apparent through a screen than during an in-person session.
Privacy may be affected if the client or therapist is in a location where other people can overhear the session.
Electronic communication and technology may carry privacy and security risks despite the use of reasonable safeguards.
If a telehealth connection is interrupted, your therapist may attempt to reconnect using the agreed-upon communication method.
Client Responsibilities During Telehealth
You are responsible for participating from a location that is reasonably private and appropriate for therapy.
You should provide your current location when requested so that your therapist can respond appropriately if an emergency occurs during a telehealth session.
You should not participate in a telehealth session while driving.
Choice of Telehealth
You may discuss questions or concerns about telehealth with your therapist. You may request an in-person appointment when available and clinically appropriate.
You may also withdraw your agreement to participate in telehealth, subject to practical considerations regarding availability and the circumstances of your treatment.
SOCIAL MEDIA AND PROFESSIONAL BOUNDARIES
Encompass Counseling maintains professional social media accounts for educational and business purposes.
To protect confidentiality and maintain appropriate therapeutic boundaries:
Your therapist will not accept friend or connection requests from current or former clients on personal social networking accounts.
Your therapist will not acknowledge or confirm a therapeutic relationship on public social media.
Clients may choose to follow or view public Encompass Counseling social media accounts.
Please avoid sharing personal or confidential information about your therapy in public comments or direct messages.
Social media direct messages are not an appropriate method for communicating clinical information, requesting clinical assistance, or addressing emergencies.
These boundaries are intended to protect your privacy and avoid conflicts or dual relationships.
ELECTRONIC COMMUNICATION RISKS
Although Encompass Counseling uses SimplePractice Secure Messaging as its preferred secure electronic communication method, no electronic system can eliminate every possible privacy or security risk.
You are responsible for protecting access to your accounts, devices, email, and other communication systems.
Please do not share your Client Portal login information with others unless specifically authorized.
MINORS
When providing services to a minor, a parent or legal guardian may be legally entitled to certain information regarding treatment.
Your therapist will discuss with the minor and parent or legal guardian what information may appropriately remain confidential, consistent with applicable law and the circumstances of treatment.
CLINICAL SUPERVISION
KayLynn Aragon, MA, LMHC, practices under the clinical supervision of Heather Georgieff, LPCC, as required by the New Mexico Counseling and Therapy Practice Board.
Clinical supervision may involve consultation regarding clinical care as permitted by law and professional requirements.
Protected health information discussed for supervision purposes will be handled in accordance with applicable privacy and confidentiality requirements.
EMERGENCIES AND CRISIS SERVICES
Encompass Counseling does not provide emergency or crisis services through voicemail, email, text messaging, Secure Messaging, or social media.
These communication methods are not continuously monitored.
If you are experiencing an emergency, are in immediate danger, or believe you may harm yourself or someone else:
Call 911
Go to the nearest emergency room
Contact an appropriate crisis or emergency service
Do not wait for a response from Encompass Counseling when immediate assistance is needed.
TREATMENT RELATIONSHIP AND COMMUNICATION OF CONCERNS
Therapy can involve difficult emotions, experiences, and conversations.
You are encouraged to tell your therapist if something does not feel helpful, comfortable, or appropriate.
Concerns about treatment, therapeutic boundaries, goals, or the therapeutic relationship can be discussed directly whenever possible.
The goal is to maintain a collaborative treatment relationship in which concerns can be addressed openly.
TERMINATION OF THERAPY
Ending therapy can be an important part of the therapeutic process.
When appropriate, termination may include reviewing progress, discussing remaining concerns, identifying next steps, and considering whether additional treatment or referrals would be helpful.
The length of the termination process may depend on the length and intensity of treatment.
Your therapist may recommend ending treatment when therapy is no longer clinically appropriate, when treatment is not being meaningfully used, or when payment obligations remain unresolved.
Whenever possible, your therapist will discuss concerns with you before ending the therapeutic relationship.
If treatment ends or you request another therapist, your therapist may provide referrals to other qualified mental health professionals when appropriate.
Extended Absence
If you do not schedule or attend an appointment for three consecutive weeks, unless prior arrangements have been made with your therapist, the professional relationship may be considered discontinued.
If you later wish to return to therapy, you may contact the practice to determine whether services are available.
CLIENT RESPONSIBILITIES
Clients are expected to:
Attend scheduled appointments or provide appropriate notice when cancelling.
Provide accurate contact and emergency information.
Participate honestly and appropriately in treatment.
Communicate concerns or changes that may affect treatment.
Maintain reasonable privacy during telehealth sessions.
Protect access to the SimplePractice Client Portal and Secure Messaging.
Use appropriate communication channels for clinical and administrative matters.
Pay agreed-upon fees and any applicable cancellation charges.
ACKNOWLEDGMENT AND INFORMED CONSENT
By signing below, I acknowledge that:
I have read and had the opportunity to ask questions about the Encompass Counseling Practice Policies & Informed Consent.
I understand the practice's appointment, cancellation, payment, and fee policies.
I understand that Encompass Counseling is a self-pay practice and does not bill insurance directly.
I understand that out-of-network insurance reimbursement, when available, is determined by my insurance plan.
I understand the difference between SimplePractice Secure Messaging and standard email or text messaging.
I understand that Secure Messaging is not monitored continuously and is not an emergency service.
I understand the risks and limitations of telehealth and have had an opportunity to discuss questions or concerns about participating in telehealth.
I understand the practice's social media and professional-boundary policies.
I understand that KayLynn Aragon practices under the clinical supervision of Heather Georgieff, LPCC.
I understand that emergency and crisis services are not provided through Encompass Counseling's electronic communication systems.
I understand that I may ask questions about my treatment, policies, or informed consent at any time.
By signing below, I consent to participate in psychotherapy services through Encompass Counseling under the policies described in this document.
Client Name: ________________
Client/Parent/Guardian Signature: _____________
Date: ______
If signed by someone other than the client, relationship/authority:
ELECTRONIC ACKNOWLEDGMENT
☐ I have read and understand the Encompass Counseling Practice Policies & Informed Consent and agree to the policies described above.
Client Name: ________________
Date: ______