I am a telehealth provider.  

However, in the event a person is in need of treatment but unable to access adequate internet service/technology - and/or has unique privacy limitations - I am currently offering a limited number of in-person sessions. In-person treatment is not guaranteed and is evaluated on an individual basis.  In-person treatment may be withdrawn at any time in response to the ever-changing safety risks associated with the Covid-19 public health crisis. 


Before choosing in-person treatment, the following information, guidelines, and protocols must be fully understood, agreed and adhered to:


Risks of Opting for In-Person Services

You understand that by coming to the office, you are assuming the risk of exposure to Covid-19 (and/or other public health risks). This risk may increase if you travel by public transportation, cab, or ridesharing service.


Your Responsibility to Minimize Your Exposure

To obtain services in person, you agree to take certain precautions to mitigate/minimize your risk of exposure. You agree to let me know if you do not adhere to risk-mitigating precautions as per Local, State, and/or Federal guidelines. While this may result in the need to return to treatment via telehealth, risk-mitigating actions are an imperative component of community safety; this includes your safety, my safety, the safety of our families, and the safety of my other patients.

  • You will only keep your in-person appointment if you are symptom free.

  • You will take your temperature either before coming to each appointment or upon arrival for your appointment. If your temperature reads above 99.6, your appointment will be cancelled. Treatment via telehealth will then resume. Late cancellation fees will not be assessed for any appointments cancelled due to Covid-19 symptoms or exposure.

  • You will wait in your car or outside until no earlier than 5 minutes before our appointment time.

  • You will wash your hands before arriving for your appointment and will use alcohol-based hand sanitizer upon entering the therapy office.

  • You will adhere to the safe distancing and exposure-minimizing precautions set up in the waiting and therapy rooms. You will not rearrange any chairs.

  • You will wear a mask upon entering and departing the building and therapy office.

  • You will help to maintain a minimum distance of 6 feet, and there will be no physical contact between you and me.

  • You agree to meet with a plexiglass barrier between us. You agree to wear your mask until seated behind the barrier and will not leave your chair without putting your mask back on.

  • You will try not to touch your face or eyes with your hands. If you do, you will immediately wash or sanitize your hands.

  • You will take steps between appointments to minimize your exposure to COVID-19.

  • If you become aware of having been exposed to another person who has tested positive for Covid-19, you will immediately let me know and we will then resume treatment via telehealth. You also agree to inform me if you have been exposed to another person who is medically presumed to have Covid-19 due to symptomology, but has been unable to access testing.

Please be aware, I may change the above precautions if additional local, state or federal orders or guidelines are published. If that happens, we will talk about any necessary changes.


My Commitment to Minimize Exposure

As per MN and Federal guidelines, I have taken steps to reduce the risk of spreading Covid-19, both within the therapy office and my personal life. The following information is also posted at the entrance of the therapy office.  Please let me know if you have questions about any of the actions I have taken.


If You or I Are Sick

You understand that I am committed to keeping you, myself, my other patients, and all of our families safe from the spread of Covid-19. If you show up for an appointment and I believe you have a fever or other Covid-19 symptoms, or if I believe you have been exposed to Covid-19, you will be required to leave immediately (and will be encouraged to seek medical care) as per MN state guidelines; telehealth services will then be initiated or resumed as per clinically appropriate.


If at any time I test positive for Covid-19, I will notify you so that you can take appropriate precautions.


Your Confidentiality in the Case of Infection

If you have tested positive for Covid-19, I may be required to notify local health authorities that you have been in the office. If I have to report this, I will only provide the minimum information necessary for their data collection and will not go into any therapy-related details about the reason(s) for our visits.  By signing this form, you are agreeing that I may do so without an additional signed release.


Office Safety Precautions in Effect During the Covid-19 Pandemic

 The following precautions have been implemented to protect myself, my patients, and our families, and to help slow the spread of Covid-19:

  • Office seating in the therapy rooms has been arranged for appropriate physical distancing.

  • Blankets, pillows, and other fabric items are no longer available for patient use during therapy sessions. In the event a fabric item is accessed/utilized for treatment purposes, it is immediately disinfected afterward with a hospital grade spray disinfectant and not used again for a minimum of 24 hours.

  • When indoors and within (approximately) 10 ft. of others, I wear a mask and/or other form of face shield, both at the office and in my personal life.

  • I strive to be mindful of maintaining safe distances from others throughout each day; both at the office and in my personal life.

  • A plexiglass barrier/partition is placed between myself and patients during therapy sessions.

  • An air purification/sanitizing unit has been purchased and is utilized throughout each session and each day when in-person treatment is being offered.

  • Patients are encouraged to wash their hands before entering building and are asked to use hand sanitizer upon entering the therapy of.

  • Hand sanitizer that contains at least 60% alcohol is available in the waiting and therapy rooms.

  • Appointments are scheduled at specific intervals to minimize likelihood of patients crossing paths.

  • All patients are asked to wait in their cars or outside until no earlier than 5 minutes before their appointment times.

  • All items touched during therapy sessions are thoroughly sanitized immediately following each session and prior to the next.

  • Physical contact between myself and my patients is strictly prohibited.

  • Tissues and trash bins are easily accessed. Trash is disposed of on a frequent basis.

  • Common areas are thoroughly disinfected in-between sessions and at the end of each day. This includes the use of an aerosol-based air sanitizer.


All persons receiving in-person treatment will be expected to agree and adhere to the protocols and guidelines as outlined above.