Information for New Clients:
Information about Dr. Fuller’s clinical policies as well as the Notice of Privacy Policies can be found in this document as well as information regarding emergencies, confidentially, fees, insurance and scheduling. The information for new clients is available at online, through our online portal, in our waiting room and from staff.
I acknowledge I have been notified how to access and read the office policies and the Federal HIPAA Ruling provided by this office.
Communications Preferences
Clients have the right to indicate methods of preferred communication. As a part of the initial session form, you will select your preferences regarding text messages, phone messages and email. You may adjust your communication preferences on the Fuller Life Portal at any time. You will choose to receive appointment reminders by SMS, email or both. Text Messages are for scheduling only. All written communication becomes a part of the clinical record.
It may become useful to communicate by email, text message, or other electronic methods of communication which are NOT typically a confidential means of communication. There is a reasonable chance that a third party may be able to intercept and eavesdrop on these electronic messages. For this reason, we offer encrypted email and a secure texting platform to ensure HIPAA-Compliance and the highest standard of electronic confidentiality. If you authorize SMS or email appointment reminders or resources from Fuller Life, please know these will not be secure or encrypted.
I have been informed of the risks, including but not limited to my confidentiality in treatment, of transmitting my protected health information by unsecured means.
Confidentiality and Social Media Policies
Dr. Fuller and Fuller Life Family Therapy are active on various social media platforms providing professional resources for mental and relational health. If you choose to follow any of our professional social media platforms, please know this may compromise your confidentiality at your own choice. Do NOT send any direct communication through these professional social media accounts.
I understand I can find out more about Fuller Life Communication Policies and Social Media Policies in the Information for New Clients Document and I will comply with the guidelines provided in these policies.
Physiological Monitoring and Video Recording:
Dr. Fuller is the founder and director of the Fuller Life Family Therapy Institute, a 501c3 non-profit post-graduatetraining organization for master’s level counselors and therapists. As a part of training, sessions at Fuller Life are automatically recorded and used for training purposes only. All video is deleted within 21 days of recording. Additionally, Dr. Fuller regularly participates in consultation to improve the quality of her clinical skills. While it is standard to use video, your consent to video is voluntary. Please talk with your therapist if you have concerns about the use of video and or physiological monitoring.
I grant permission to use physiological monitoring and video for training and to enhance clinical care.
Routine Outcome Measures Consent for Research
As a standard of care at Fuller Life, we administer routine outcome measures (ROM), also called Feedback informed therapy (FIT). There is substantial evidence that using assessments as part of therapy improves the success rate. Tracking the progress and outcome of therapy has been shown to double the efficacy of the therapy experience. Clients will receive an invitation to complete a set of surveys prior to each session. Every 5th session the original survey set will be re-administered to evaluate progress.
This information and feedback will not only help to enhance the therapy services you receive, but also have a potential role in research and training. Consequently, we are asking your permission to use your anonymizedresponses on these questionnaires for research purposes. The risk to you is minimal as any personal identifiers will be removed.
Although you will be expected to fill out the questionnaires as part of your treatment, your decision to allow the data to be used for research purposes in completely voluntary. You may refuse to participate in the research portion of the assessments without penalty and you may withdraw your permission at any time. If you have questions, please talk to your therapist or contact Dr. Fuller at amy@fullerlifefamilytherapy.org.
I agree to have my non-identifiable information used for research purposes.
Therapy conducted with the assistance of technology has certain risks that must be considered. Please see our information on the risks and benefits of Telemental health, as well as things you and your therapist will want to keep in mind to ensure your confidentiality, safety and how to connect in the case of a technological difficulty. Participation in electronic supported therapy is voluntary. Please read about Telemental health as a part of the information for new clients.
It is important that your therapist can contact you if you lose connection during telehealth. It is also important that we have the physical address where you are located in the rare case of an emergency.