Vanessa J. Honn, Ph. D.

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Vanessa Honn, Ph.D. Welcome to my practice at Rainier Behavioral Health. I look forward to working with you. The following information is designed to help our work go as smoothly as possible. I welcome the opportunity to discuss any questions or concerns you may have regarding this agreement or my services. CREDENTIALS: I am licensed as a psychologist in Washington State (#2973). I have a Ph.D. in clinical psychology from The Ohio State University and completed formal postdoctoral training in clinical psychology, neuropsychology, and behavioral medicine at the Boston VA and Boston University. I am a member of the American Psychological Association and the Washington State Psychological Association. APPROACH TO EVALUATION AND TREATMENT: My practice focuses on the treatment and evaluation of adults. I cannot promise to make any particular diagnosis or to reach any particular conclusion from an evaluation, nor can I promise any particular therapeutic outcome. Psychotherapy: My approach to treatment is both supportive and problem-focused. I work actively with my clients to identify areas for change, improve self-awareness, enhance current strengths, and generate solutions. Successful psychotherapy requires the mutual effort of client and therapist. I will use the best of my abilities to help you overcome the difficulties that led you to seek psychological help. You always have the right to request a change in treatment or to refuse treatment, and you are free to discontinue therapy at any time. It is essential that what we do together meets your needs. If you believe you are not being helped, please tell me so that we can work through that difficulty together. Should you choose to discontinue therapy with me but wish to continue treatment, I can assist you in finding another therapist. 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. CANCELLATIONS: If you are unable to keep your appointment for any reason, please contact the office to cancel or reschedule at least one full business day (24 hours) in advance. Otherwise, you will be charged $75.00 for the missed appointment. Insurance will not pay for missed appointments, so you will be responsible for this fee. 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 or will contact the on-call clinician if I am not available. Due to the nature of an outpatient practice, it may not be possible for us to respond immediately. If a situation requires an immediate response, please ask our answering service for further instructions, call 911, or go to the nearest hospital emergency room. CASE CONSULTATION AND REFERRAL SOURCES: If you have been referred to me by another health provider, I may acknowledge that you have made contact with me and provide that provider with a written report. If you do not want me to do this, please notify me during your first visit. Because I am committed to providing the best possible care, I may at times consult with the other professionals in our group practice if I feel they have some expertise in an area which is relevant. The other professionals are bound by the same rules of confidentiality as discussed in this agreement. FEES: My fees are $270 for an initial psychotherapy appointment or consultation session, $235 for each testing session, $255 for each psychotherapy or consultation session, and $145 for each half session. For behavioral medicine services, in which the primary focus of treatment is a medical condition, my fee is $255 per session. Fees for reports, letters, review of materials, and phone calls will be charged at $245 per hour on a pro-rated basis according to time actually required. INSURANCE: I am a contracted provider for many, but not all, insurance companies. You should check with your insurance company 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 maximum yearly dollar amount. Even if the staff in my office is checking into benefits and authorization on your behalf, it is important that you verify this information. 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 provided to you with this office policy as well as a copy of your insurance card. It is your responsibility to alert our staff of any changes to your insurance, as the billing staff will not be automatically notified of these changes. ETHICS AND PROFESSIONAL STANDARDS: As a licensed psychologist, I am accountable for my work with you. I work to uphold the highest ethical and professional standards at all times. The relationship between client and psychologist is a special one that requires considerable trust. Ethical guidelines prohibit dual relationships. Therefore, social or business interaction outside of the context of therapy or evaluation is discouraged. Intimate contact between therapist and client is always inappropriate. If you have any concerns about the course of treatment or evaluation, please discuss them with me. The Board of Psychology Examiners in Olympia (360-753-9772) is also available to respond to your questions or concerns. 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: I hereby authorize Vanessa J. Honn, Ph.D. to render psychological services. This authorization constitutes informed consent without exception. I have read and understand this Office Policy Statement 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.

Please note: Rainier Behavioral Health does not provide disability evaluations or court related evaluations.

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