If you are experiencing a mental health or medical emergency, please call 911 or go to your nearest emergency room. This website offers the opportunity to connect with professional psychological treatment and effective coaching. The Sassy Shrink and the information provided on this website are not designed for crisis management. Please call your local crisis support should you need immediate attention.
Please read this entire disclaimer notice before using this website, scheduling an appointment or making a purchase on this site, or relying on the content published within it. If you schedule an initial session with Jaclyn or make a purchase from The Sassy Shrink we will assume that you have read and understand this disclaimer notice. For privacy information regarding this website please visit the privacy policies.
At this time, The Sassy Shrink is not affiliated with other parties and does not accept financial gain from referral. The Sassy Shrink reserves the right to change or update this disclaimer notice, or any other of our policies or practices, at any time without notice. Any changes or updates will be effective immediately upon posting to this website.
Limitation Of Liability
The staff at The Sassy Shrink are dedicated to your advancement and overall well-being. We respect the rights of those persons seeking assistance, and we make reasonable efforts to ensure that our services are used appropriately. The Sassy Shrink and each individual coach and counselor is qualified, trained, and insured.
Confidentiality & Special Concerns
Information disclosed in session is confidential and will not be disclosed to anyone without written permission from you, the client. However, Pennsylvania law requires the following exceptions to client confidentiality: please see privacy policies.
If you choose to file insurance claims and you request a statement to do so, your statement will contain a diagnosis. This information becomes part of the client record and your medical record in perpetuity. Confidentiality cannot be guaranteed in groups. In working with couples and families, free flow of information is imperative, consequently your therapist is advised not to hold secrets and will always endeavor to facilitate difficult conversations between parties and do so within the state of Pennsylvania legal and ethical guidelines.
Cancellation, Reschedule, Refund Policy
If you choose to work with us at The Sassy Shrink, you will see the following information described in your consent forms in Simple Practice. All staff at The Sassy Shrink are diligent and mindful about scheduling. When an appointment is scheduled, that time is reserved for you, and we turn others away to hold a place in our schedule for you. The Sassy Shrink requires a full 24 hours notice for cancellations or reschedules so we can provide services to those patiently waiting. If you choose, for any reason not to attend or choose to reschedule an appointment without providing 24 hr. advance notice, full fee will be charged. We always encourage rescheduling within the week and avoiding the fee if possible.
The Sassy Shrink provides two services: counseling and coaching, in one individual session or as a package of 10. You can meet with any of the Sassy supports with your package of 10 in a coaching and/or counseling fashion. We have found 10-12 sessions to be optimal for most of our clients and we follow this protocol with the understanding that more or fewer sessions may be preferable for your situation. We can discuss this in your initial session with Jaclyn. Your coach or counselor will work with you to help you achieve your goals yet The Sassy Shrink and your therapist cannot make any outcome guarantees.
In the event you and your counselor/coach determine that a shorter course of treatment is appropriate, The Sassy Shrink will make billing adjustments and/or you may request a refund for any unused sessions. There are no refunds for completed sessions and your credit card on file with Simple Practice will be charged only when the service is complete. Requests for refunds for unused sessions must be submitted in writing within 30 days of the appointment of reference. We appreciate your patience as processing time for refunds could take up to 6 weeks from the date of request.
Disclaimer Notice Changes
The Sassy Shrink reserves the right to change or update this disclaimer notice, or any other of our policies or practices, at any time without notice. Any changes or updates will be effective immediately upon posting to this website. Under certain circumstances, we may also elect to notify you of changes or updates to our disclaimer notice by additional means such as Simple Practice or email in addition to posting on the front page of our website. We encourage you to review this disclaimer notice often for changes. If you have any questions or comments, please reach out to us:
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY
Your health information is personal and private, and we must protect it. This notice tells you how the law requires or permits us to use and disclose your health information. It also tells you what your rights are and what we must do to use and disclose your health information.
We must by law:
• Keep your health information (also known as “protected health information” or “PHI”) private
• Give you this Notice of our legal duties and privacy practices regarding your PHI
• Obey the terms of the current Notice in effect
Changes to this Notice:
We have the right to make changes to this Notice and to apply those changes to your PHI. If we make changes, you have the right to receive a copy of them in writing. To obtain a copy, you may ask your service provider or any staff person.
HOW THE LAW PERMITS US TO USE AND DISCLOSE INFORMATION ABOUT YOU
We may use or give out your health information (PHI) for treatment, payment or health care operations. These are some examples:
Health care professionals, such as doctors and therapists working on your case, may talk privately to determine the best care for you. They may look at health care services you had before or may have later on.
We need to use and disclose information about you to get paid for services we have given you. For example, insurance companies ask that our bills have descriptions of the treatment and services we gave you to get payment.
For Health Care Operations:
We may use and disclose information about you to make sure that the services you get meet certain state and federal regulations. For example, we may use your protected health information to review services you have received to make sure you are getting the right care.
USES AND DISCLOSURES THAT DO NOT NEED YOUR AUTHORIZATION
To Other Government Agencies Providing Benefits or Services:
We may give information about you to other government agencies that are giving you benefits or services. The information we release about you must be necessary for you to receive those benefits or services.
To Keep You Informed:
We may call or write to let you know about your appointments. We may also send you information about other treatments that may be of interest to you.
We may give your PHI to researchers for a research project that has gone through a special approval process. Researchers must protect the PHI they receive.
As Required by Law:
We will give your PHI when required to do so by federal or state law.
To Prevent a Serious Threat to Health or Safety:
We may use and give your PHI to prevent a serious threat to your health and safety or to the health and safety of the public or another person.
We may give your PHI for worker’s compensation or programs that may give you benefits for work-related injuries or illness.
Public Health Activities:
We may give your PHI for public health activities, such as to stop or control disease, stop injury or disability, and report abuse or neglect of children, elders and dependent adults.
Health Oversight Activities:
We may give your PHI to a health oversight agency as authorized by law. Oversight is needed to monitor the health care system, government programs and compliance with civil rights laws.
Lawsuits and Other Legal Actions:
If you have a lawsuit or legal action, we may give your PHI in response to a court order.
We may give your PHI when asked to do so by law enforcement officials: In response to a court order, warrant, or similar process; To find a suspect, fugitive, witness, or missing person; If you are a victim of a crime and unable to agree to give information to report criminal conduct at any of our locations; or to give information about a crime or criminal in emergency circumstances.
Coroners and Medical Examiners:
We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death.
National Security and Intelligence Activities:
We may give your PHI to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
Protective Services for the President and Others:
We may give your PHI to authorized federal officials so they may protect the President and other heads of state or do special investigations. Other uses and disclosures of your PHI, not covered by this Notice or the laws that apply to us, will be made only with your written authorization. If you give us authorization to use or give out your PHI, you can change your mind at any time by letting your service provider know in writing. If you change your mind, we will stop using or disclosing your PHI, but we cannot take back anything already given out. We must keep records of the care that we gave you.
YOUR RIGHTS ABOUT YOUR PROTECTED HEALTH INFORMATION (PHI)
Right to See and Copy:
Federal regulations say that you have the right to ask to see and copy your PHI. However, psychiatric and drug and alcohol treatment information is covered by other laws. Because of these laws, your request to see and copy your PHI may be denied. You can get a handout about access to your records by asking your health care provider. A therapist will approve or deny your request. If approved, we may charge a fee for the costs of copying and sending out your PHI. We may also ask if a summary, instead of the complete record, may be given to you. If your request is denied, you may appeal and ask that another therapist review your request.
Right to Ask for an Amendment:
If you believe that the information we have about you is incorrect or incomplete, you may request changes be made to your PHI as long as we maintain this information. While we will accept requests for changes, we are not required to agree to the changes. We may deny your request to change PHI if it came from another health care provider, if it is part of the PHI that you were not permitted to see and copy, or if your PHI is found to be accurate and complete.
Right to Know to Whom We Gave Your PHI:
You have the right to ask us to let you know to whom we may have given your PHI. Under federal guidelines, this is a list of anyone that was given your PHI not used for treatment, payment and health care operations or as required by law mentioned above. To get the list, you must ask your service provider in writing for it. You cannot ask for a list during a time period over six years ago or before April 14, 2003. The first list you ask for within a 12-month period will be free. For more lists, we may charge you for the cost of copying and sending the list. We will let you know the cost, and you may choose to stop or change your request before it costs you anything.
Right to Ask Us to Limit PHI:
You have the right to ask us to limit the PHI that the law lets us use or give about you for treatment, payment or health care operations. We don’t have to agree to your request. If we do agree, we will comply with your request unless the PHI is needed to give you emergency treatment. To request limits, you must ask your service provider in writing. You must tell us (1) what PHI you want to limit; (2) whether you want to limit its use, disclosure or both; and (3) to whom you want the limits to apply.
Right to Ask for Privacy:
You have the right to ask us to tell you about appointments or other matters related to your treatment in a specific way or at a specific location. For example you can ask that we contact you at a certain phone number or by mail. To request that certain information be kept private, you must ask your service provider in writing. You must tell us how or where you wish to be contacted.
Right to a Paper Copy of This Notice:
You may ask us for a copy of this Notice at any time. Even if you have agreed to receive this Notice by e-mail, we will give you a paper copy of this Notice. You may ask any staff person for a copy.
If you believe your privacy rights have been violated, you may submit a complaint with us or with the Federal Government. Filing a complaint will not affect your right to further treatment or future treatment.
To file a complaint with the Federal Government, contact:
Secretary of the U.S. Department of Health and Human Services, Office of Civil Rights, Region III, Regional Manager, Paul Cushing 150 S. Independence Mall West, Suite 372, Public Ledger Bldg, Philadelphia, PA 19106-9111 - Phone (215) 861-4441 - Web site www.hhs.gov/region3 - Hotline (800) 368-1019 - Fax (215) 861-4431 - TDD (215) 861-4440 - E-mail firstname.lastname@example.org