Current Clients: New rates will go into effect beginning January 1, 2018, unless discussed other arrangements. 

Current and New Clients: Please Review and initial at each designated area under the "Forms" section.

____      "I have reviewed the following information provided to me, from the Serendipity Patient Portal, or from www.SerendipityResolutions.com (when it is up and running) and understand what I have read."  

_____   Client Information

_____   Notice of Privacy Practices/HIPPA

_____   Emergency Contact Information

_____   Fees within the Fee Agreement

Periodically we will review the Fee Agreement. The fee agreement states you are authorizing Serendipity Resolutions & Counseling, PLLC to:

____      Have 2 credit cards on file via the Secure Patient Portal

____      Charge the credit card(s) for the counseling fee, either, at the time of the appointment or thereafter. If you want to pay online yourself that is also acceptable.

____      Charge for time spent on the phone or via text or e-mail, at $150 per hour (prorated to the nearest hour and thereafter, half-hour)

____      Charge for time spent, same as above, with other parent, an attorney or other professionals, in relation to the client (you or child), at $150 per hour (prorated to the nearest hour and thereafter, half-hour)

____      Charge ANY balance via credit card (counseling or other) if payment is NOT received within 48 hours

____      Although it should not be needed due to the above practices, if there is an outstanding balance, Serendipity Resolutions & Counseling, PLLC can submit to the court or to a collection agency and their fees will also be added to the balance.

____      Charge or collect another way, full payment prior to a court appearance. You are waiving my subpoena if this is not possible. If the other party is subpoenaing me, you MUST pay it in full and ask for repayment from that party at the time of court.

Thank you for the opportunity to serve you and/or your child(ren). Going over fees is not fun but necessary to protect all involved in the process.