(Please initial and date each statement.)
The current fee for counseling sessions is $75. The payment is due at the time of service at the beginning of the session. Grace For All Families counseling practice accepts the following as payment: cash, credit or debit card, or personal checks.
Checks should be made payable to Grace For All Families. In the event of a returned check, the client should make every effort to pay for the session as soon as possible.
Grace For All Families has a 24-hour cancellation policy. Please be courteous of my time and the time of others- if you cannot keep the appointment, let me know so someone can have it. Failure to cancel or reschedule within 24 hours of your appointment will result in a $20 office charge to be paid at the next visit. No-shows to appointments results in the forfeiture of services provided by Grace For All Families.
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(Parents: please fill out this section if child is younger than 13. If they are 13 or older, have them fill out this section themselves.)
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Any requests for statements, affidavits, subpoenas needed for family court, etc, are subject to Clergy Privilege and will be reviewed by Dr. Ransom on a case by case basis. According to Georgia Mental Health and Developmental Disabilities Confidentiality Act, subpoenas for any client records need only be answered if sent from a judge’s office, not a lawyer. Thanks
Please initial below indicating that you understand this policy.
Regarding requests by clients to appear in court as a professional witness, please be advised that most of the time, the court will not recognize the counselor’s testimony due to hearsay. Please initial below indicating that you understand this policy.