1. APPOINTMENTS AND CANCELLATIONS

Please remember to cancel or reschedule 24 hours in advance. You will be responsible for the entire fee if cancellation is less than 24 hours.

The standard meeting time for therapy is between 45-60 minutes depending on insurance reimbursement and client needs.

A $25 service charge will be charged for any checks returned for any reason for special handling.

Cancellations and re-scheduled sessions will be subject to a full charge if NOT RECEIVED AT LEAST 24 HOURS IN ADVANCE. This is necessary because a time commitment is made to you and is held exclusively for you. If you are late for a session, you may lose some of that session time.

2. TELEPHONE, TEXT, AND OTHER ELECTRONIC COMMUNICATION

We cannot ensure the confidentiality of any form of communication through electronic media, including text messages beyond our third-party vendors’ security capabilities, but we assure you that these vendors are some of the best in the industry.

We use two types of communication channels: HIPAA-Compliant for Protected Health Information (PHI) and other sensitive information, and non-HIPAA-compliant for fast and convenient communication that doesn’t contain PHI. Our EHR app and our Client Portal website provide HIPAA-compliant features such as text messaging, video conference, telehealth, document uploading, and electronic signing of intake and other forms. Your PHI is also protected when we use direct phone discussions or voicemail. When using non-HIPAA-compliant channels such as email and SMS, please do NOT share any sensitive information.

While we may try to return messages in a timely manner, we cannot guarantee an immediate response since we are often not immediately available; however, we promise we will attempt to return your call within 24 hours. If a true emergency situation arises, please call 911 or any local emergency room.

Regarding SMS messages, during the intake process, via the secured Client Portal, you will receive the SMS Consent Form to Opt-In to receive text messages to your cell phone. We only use text messages for basic communication (ex. scheduling, directions, parking info, etc.) and not for any sensitive information. If you decide to agree to the items contained in that document, you will have the option at any time to Opt-Out from receiving SMS messages by texting 'STOP' to 708-763-9582. After opting out, you will no longer receive further messages unless you opt back in. To do that, reply “Yes” to a previous text. Standard messaging and data rates may apply depending on your mobile carrier and plan. You are responsible for any charges incurred from receiving messages. The frequency of these messages may vary depending on the therapist and other clinic personnel’s needs. For assistance either reply “HELP”, call 708-763-9582, or go to kidsconnect.care. Visit kidsconnect.care/privacy-policy to see our privacy policy and kidsconnect.care/terms for this Terms of Service.

Privacy Policy: As with all other data, we will not share or sell for marketing purposes your cellphone information with anyone. For more information about how we collect, use, and protect your personal data, please refer to our Privacy Policy at https://kidsconnect.care/privacy-policy.

3. TELEHEALTH

Please note that Face-to-face sessions are highly preferable to phone or video conference sessions. However, in the event that you are out of town, sick, or need additional support, phone and video teleconference sessions are available.

Services by electronic means, including but not limited to telephone communication, the Internet, facsimile machines, and e-mail is considered telemedicine by the State of Illinois. Under the Illinois Telemedicine law, telemedicine is broadly defined as the use of information technology to deliver medical services and information from one location to another. If you and your therapist choose to use information technology for some or all of your treatment, you need to understand that:

You retain the option to withhold or withdraw consent at any time without affecting the right to future care or treatment or risking the loss or withdrawal of any program benefits to which you would otherwise be entitled.

All existing confidentiality protections are equally applicable.

Your access to all medical information transmitted during a telemedicine consultation is guaranteed, and copies of this information are available for a reasonable fee.

Dissemination of any of your identifiable images or information from the telemedicine interaction to researchers or other entities shall not occur without your consent.

There are potential risks, consequences, and benefits of telemedicine. Potential benefits include, but are not limited to improved communication capabilities, providing convenient access to up-to-date information, consultations, support, reduced costs, improved quality, change in the conditions of practice, improved access to treatment, better continuity of care, and reduction of lost work time and travel costs. Effective treatment is often facilitated when the healthcare provider gathers within a session or a series of sessions, a multitude of observations, information, and experiences about the client. The provider may make assessments, diagnosis, and interventions based not only on direct verbal or auditory communications, written reports, and third person consultations, but also from direct visual and olfactory observations, information, and experiences. When using information technology in services, potential risks include, but are not limited to the provider’s inability to make visual and olfactory observations of clinically or therapeutically potentially relevant issues such as: your physical condition including deformities, apparent height and weight, body type, attractiveness relative to social and cultural norms or standards, gait and motor coordination, posture, work speed, any noteworthy mannerism or gestures, physical or medical conditions including bruises or injuries, basic grooming and hygiene including appropriateness of dress, eye contact (including any changes in the previously listed issues), sex, chronological and apparent age, ethnicity, facial and body language, and congruence of language and facial or bodily expression. Potential consequences thus include the provider not being aware of what he or she would consider important

4. SOCIAL MEDIA

Due to the importance of your confidentiality and the importance of minimizing dual relationships, we only accept friend or contact requests from current or former clients on social networking sites that pertain to KidsConnect Pediatric Therapy clinic updates and news (Facebook, LinkedIn, etc). We believe that adding clients as friends or contacts on these sites, on a personal level, can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up when we meet and we can talk more about it.

5. MINORS

If you are a minor, your parents may be legally entitled to some information about your treatment. We will discuss with you and your parents what information is appropriate for them to receive and which issues are more appropriately kept confidential.

6. TERMINATION

Ending relationships can be difficult. Therefore, it is important to have a termination process in order to achieve some closure. The appropriate length of the termination depends on the length and intensity of the treatment. We may terminate treatment after appropriate discussion with you and a termination process if we determine that the treatment is not being effectively used or if you are in default on payment. We will not terminate the therapeutic relationship without first discussing and exploring the reasons and purpose of terminating. If treatment is terminated for any reason or you request another provider, we will provide you with a list of qualified pediatric occupational therapists to treat you. You may also choose someone on your own or from another referral source. Should you fail to schedule an appointment for three consecutive weeks, unless other arrangements have been made in advance, for legal and ethical reasons, we must consider the professional relationship discontinued.

DURING THE INTAKE PROCESS, VIA THE CLIENT PORTAL, THE CLIENT WILL RECEIVE AND BE ASKED TO READ AND AGREE TO THE ITEMS CONTAINED IN THIS DOCUMENT.

EFFECTIVE DATE OF THIS NOTICE

This notice went into effect on 12/03/2024