Natalie G. Glover, Ph.D.

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Natalie, Glover, Ph.D. Welcome! Below, please find useful information regarding your treatment. APPOINTMENTS: Your appointment time is held exclusively for you. It is important that you arrive on time for your appointment, as it cannot be extended. If you are unable to keep your appointment for any reason, please contact the office at least 24 hours in advance to cancel or reschedule; otherwise, you will be charged $75 for the missed session. This office does not give reminder calls for appointments. It is your responsibility to remember and keep track of your appointments. As insurance will not pay for missed sessions, you will be responsible for the charge. CREDENTIALS: I am a psychologist licensed in the State of Washington. I earned a doctoral degree (Ph.D.) in Clinical Psychology from the University of Kentucky and completed an internship in Clinical Psychology at VA Puget Sound: American Lake Division. I also completed my Clinical Psychology postdoctoral residency at VA Puget Sound, with an emphasis in chronic pain management. I work to uphold the highest ethical standards, and am also committed to culturally-sensitive awareness and care. PROCESS OF THERAPY: Psychotherapy is a dynamic process in which we will be working together to help move you in the direction of your goals and to live a life that you value. Therapy has the potential to help you break unhealthy life patterns, learn to relate to unpleasant emotions in a more workable way, and foster a sense of purpose and self-worth. To accomplish your goals, we both need to work together. I will do my best to provide effective treatment, and you will need to make a commitment to be open, aware, and engaged—both inside and outside of therapy. As you navigate through the process of therapy and through life, I will serve as a helpful guide and provide you with a safe, supportive place to speak, change, and grow. You, however, will always be in the driver’s seat, and your willingness to do good work (even when it is difficult) will be the most important factor in your success. I utilize an approach to therapy that integrates different modalities based on an individual’s needs, and I welcome feedback from you at any point along the way. Also know that you always have the right to request a change of therapy, referral to another therapist, or to discontinue therapy at any time. EMERGENCY CALLS: An Answering Service takes all emergency calls outside of regular business hours. This service will attempt to locate me in the event of an emergency and will contact the on-call therapist if I am not available. After hours calls are typically charged a fee based on a prorated amount for the length of the call. You may also call the crisis line at: 253-798-4333 (Pierce County) or 206-461-3222 (King County). BILLING AND PAYMENTS: Patients, or their responsible legal guardian, are responsible for their accounts and are expected to pay their bill when due, whether medical insurance pays for a portion or not, including charges for evaluation, printed materials, reports, letters, consultations and telephone calls. A finance charge of 1% per month may be added to any balance not paid within 60 days after the charge was incurred. When 90 days have passed without a payment or prior arrangement with me, accounts may be sent for collection and the patient or legal guardian may be responsible for any additional legal and/or collection agency charges. Results of evaluation or reports may not be released until accounts are paid in full. I understand that this is an expensive treatment and I am prepared to arrange an extended payment plan. This entails a written agreement to pay a fixed amount regularly each month until the balance is paid. If regular payments stop, the balance will be considered delinquent, and finance charges and collection procedures may be instituted. Bills are sent out monthly and detail the dates of visits, the type of service provided, whether your insurance company has been billed for that visit, and all payments made into your account. If you have any questions about your bill, please ask me or our billing department. You are expected to pay for each session at the time it is held, unless we agree otherwise or unless you have insurance coverage. If you have insurance coverage you are expected to pay your co-pay at the time of each appointment. The co-pay for mental health is often different from that for other medical visits. If you are uncertain about your co-pay, I encourage you to contact your insurer. Until you know for certain what your co-pay is, I would ask that you pay 20% of my fee (e.g., $40) at the time of each appointment. INSURANCE: I am a contracted provider for most local insurance companies. You should be sure to check with your insurer and my intake office to learn whether I am a provider for your plan. You should also learn whether you need a referral or preauthorization in order to be eligible for your mental health benefit, whether you have a separate annual deductible for mental health, and whether your mental health benefit has a maximum yearly number of visits or a maximum yearly dollar amount. My billing department will submit claims to insurance companies that I am contracted with. In order for this to occur you must complete the insurance portion of the “Patient Information” form that was given to you with this office policy; you also need to provide a copy of your insurance card. CHANGES TO THIS OFFICE POLICY: From time to time I may change the business policies described in this document; I will attempt to notify you of relevant changes. INFORMED CONSENT: Your signature below indicates that you have read the information in this document and agree to abide by its terms during our professional relationship. INFORMED CONSENT FOR ADULTS: I hereby authorize Natalie G. Glover, Ph.D., a licensed psychologist, to render psychological services. This authorization constitutes informed consent without exception. I have read and understand the office policy statement and notice of privacy practices and have received a copy of this office policy for myself.

* I acknowledge I have read the financial policy above and that I am responsible for all charges regardless of any insurance coverage I have. I understand that delinquent accounts may be assigned to a credit reporting collection agency and agree to pay for all legal costs and expenses including reasonable attorney fees. By signing this Acknowledgement, I agree that my electronic signature is the legally binding equivalent to my handwritten signature. Whenever I execute an electronic signature, it has the same validity and meaning as my handwritten signature. I will not, at any time in the future, repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding.

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