Bend Health therapy - required information by state
Please select your state below to review important information for teletherapy clients, as required per the individual state’s specific requirements.
If your state is not listed, there is not a required notice. For any questions, please contact hello@bendhealth.com or (800) 516-0975.
Colorado
Tel: (303) 894-7800
California notice to clients
The Board of Behavioral Sciences receives and responds to complaints regarding services provided within the scope of practice of clinical social workers, professional clinical counselors, and marriage and family therapists. You may contact the board online at www.bbs.ca.gov, or by calling (916)574-7830.
Your health plan’s contracted network providers may also offer in-office appointments. Health plan’s telehealth and in-person services are subject to the same timely access to care standards. If you have out-of-network benefits, and utilize out-of-network services, you are subject to the plan’s cost-sharing obligation and balance billing protections. Contact your health plan to learn more.
You have a right to access your medical records. Records of the care you receive from Bend Health will be shared with your primary care provider (PCP) via an electronic patient record system or provided in a different manner unless you opt out.
Maryland teletherapy disclosure statement
Welcome
Before you begin receiving teletherapy services from Bend Health, we’d like to share the information below with you, as required by the Maryland Board ofExaminers for Social Workers and Professional Counselors. Please read through this document carefully and ask your therapist about information that seems unclear before you begin counseling, or at any time throughout your course of treatment.
Your rights
As licensed therapists, we desire to integrate sound cognitive behavioral therapy principles in your treatment. You are entitled to receive information from any therapist concerning our methods of therapy, the techniques used, an estimation of the duration of your treatment, risks and benefits of counseling, confidential communication, and access to your records. You also have the right to know what other treatment options are available and the possible effectiveness of those alternatives. You may at any time seek a second opinion from another clinician and/or terminate the counseling process. Therapists need to be informed if you are working with more than one counselor. In a professional relationship with a therapist, sexual intimacy is never appropriate and should be reported to the board that licenses, registers, or certifies that therapist.
HIPAA provides you with several new or expanded rights regarding your Clinical Record and disclosures of protected health information. These rights include requesting that your therapist amend your record; requesting restrictions on what information from your Clinical Record is disclosed to others; requesting an accounting of any disclosures of protected health information that you have neither consented to nor authorized; determining the location to which protected information disclosures are sent; having any complaints you make about our policies and procedures recorded in your records; and the right to another copy of this Notice upon request.
Disclosure of experience, degrees, licensing, and other certifications
You have the right to be informed regarding the degrees, credentials, certifications, registrations, and licenses held or obtained by your therapist. This includes the education, experience and training that were required to satisfy the degrees, credentials, certifications, registrations, and licenses. We have multiple licensed therapists who are working through our teletherapy practice.
This information is required by the Maryland Board of Social Workers as well as the Maryland Board of Professional Counselors and Therapists. The boards can be contacted at:
4201 Patterson Avenue
Baltimore, MD 21215
Phone: (410) 764-4788
Fax: (410) 358-2469
Toll Free: 1 (877) 526-2541
TDD: 1 (800) 542-4964
Michigan teletherapy disclosure statement
Welcome
Before you begin receiving teletherapy services from Bend Health, we’d like share the information below with you, as required by the Michigan Public Health Code and the Michigan Dept. of Licensing and Regulatory Affairs (LARA). Please read through this document carefully and ask your therapist about information that seems unclear before you begin counseling, or at anytime throughout your course of treatment.
Your rights
As licensed therapists, we desire to integrate sound cognitive behavioral therapy principles in your treatment. You are entitled to receive information from any therapist concerning our methods of therapy, the techniques used, an estimation of the duration of your treatment, risks and benefits of counseling, confidential communication, and access to your records. You also have the right to know what other treatment options are available and the possible effectiveness of those alternatives. You may at any time seek a second opinion from another clinician and/or terminate the counseling process. Therapists need to be informed if you are working with more than one counselor. In a professional relationship with a therapist, sexual intimacy is never appropriate and should be reported to the board that licenses, registers, or certifies that therapist.
HIPAA provides you with several new or expanded rights regarding your Clinical Record and disclosures of protected health information. These rights include requesting that your therapist amend your record; requesting restrictions on what information from your Clinical Record is disclosed to others; requesting an accounting of any disclosures of protected health information that you have neither consented to nor authorized; determining the location to which protected information disclosures are sent; having any complaints you make about our policies and procedures recorded in your records; and the right to another copy of this Notice upon request.
Disclosure of experience, degrees, licensing, and other certifications
You have the right to be informed regarding the degrees, credentials, certifications, registrations, and licenses held or obtained by your therapist. This includes the education, experience and training that were required to satisfy the degrees, credentials, certifications, registrations, and licenses. We have multiple licensed therapists who are working through our teletherapy practice.
This information is required by the Michigan Public Health Code and the Michigan Dept. of Licensing and Regulatory Affairs (LARA). Any and all complaints related to Licensed Professional Counselors can be directed to:
Michigan Department of Licensing and Regulatory Affairs Bureau of Professional Licensing
ATTN: Complaint Intake
Section 611
W. Ottawa Street
PO Box 30670
Lansing, MI 48909-8170
E-Mail: BPL-Complaints@michigan.gov
Fax: (517) 241-2389
Minnesota client bill of rights
A therapist must display prominently on the premises of the professional practice or make available as a handout the bill of rights of clients, including a statement that consumers of marriage and family therapy services offered by marriage and family therapists licensed by the state of Minnesota have the right:
- To expect that a therapist has met the minimal qualifications of education, training, and experience required by state law;
- To examine public records maintained by the Board of Marriage and FamilyTherapy that contain the credentials of a therapist;
- To report complaints to the Board of Marriage and Family Therapy;
- To be informed of the cost of professional services before receiving the services;
- To privacy as defined and limited by rule and law;
- To be free from being the object of unlawful discrimination while receiving services;
- To have access to their records as provided in Minnesota Statutes, sections 144.291 to 144.298, except as otherwise provided by law or prior written agreement;
- And to be free from exploitation for the benefit or advantage of a therapist.
New Jersey teletherapy disclosure statement
Welcome
Before you begin receiving teletherapy services from Bend Health, we’d like to share the information below with you, as required by the New Jersey State Department of Regulatory Agencies and other governing bodies. Please read through this document carefully and ask your therapist about information that seems unclear before you begin counseling, or at any time throughout your course of treatment.
Your Rights
As licensed therapists, we desire to integrate sound cognitive behavioral therapy principles in your treatment. You are entitled to receive information from any therapist concerning our methods of therapy, the techniques used, an estimation of the duration of your treatment, risks and benefits of counseling, confidential communication and access to your records. You also have the right to know what other treatment options are available and the possible effectiveness of those alternatives. You may at any time seek a second opinion from another clinician and/or terminate the counseling process. Therapists need to be informed if you are working with more than one counselor. In a professional relationship with a therapist, sexual intimacy is never appropriate and should be reported to the board that licenses, registers, or certifies that therapist.
HIPAA provides you with several new or expanded rights regarding your Clinical Record and disclosures of protected health information. These rights include requesting that your therapist amend your record; requesting restrictions on what information from your Clinical Record is disclosed to others; requesting an accounting of any disclosures of protected health information that you have neither consented to nor authorized; determining the location to which protected information disclosures are sent; having any complaints you make about our policies and procedures recorded in your records; and the right to another copy of this Notice upon request.
Disclosure of experience, degrees, licensing, and other certifications
You have the right to be informed regarding the degrees, credentials, certifications, registrations, and licenses held or obtained by your therapist. This includes the education, experience and training that were required to satisfy the degrees, credentials, certifications, registrations and licenses. We have multiple licensed therapists who are working through our teletherapy practice.
Social workers are licensed or certified by the Board of Social Work Examiners, an agency of the Division of Consumer Affairs. You may notify the Board of any complaints relative to the practice conducted by a social worker. The Board's address is:
Division of Consumer Affairs, Board of Social Work Examiners
Post Office Box 45033
124 Halsey St
Newark, NJ 07101
Professional Counselors and associate counselors are licensed by the Board of Marriage and Family Therapy Examiners, Professional Counselor Examiners Committee, an agency of the Division of Consumer Affairs. Any member of the consuming public having a complaint relative to the practice conducted by a professional counselor associate counselor shall notify the professional counselor examiners committee or the New Jersey Division of Consumer Affairs:
Professional Counselor Examiners Committee
PO Box 45007
124 Halsey St
Newark, NJ 07101
www.njconsumeraffairs.gov/pc
New Jersey Division of Consumer Affairs
PO Box 45027
124 Halsey St
Newark, NJ 07101
All Marriage and Family Therapists are licensed by the State Board of Marriage and Family and Family therapy examiners, an agency of the NJ Division of Consumer Affairs. Any member of the consuming public having a complaint relative to the practice conducted by a professional counselor associate counselor shall notify the professional counselor examiners committee or the New Jersey Division of Consumer Affairs:
Professional Counselor Examiners Committee
PO Box 45007
124 Halsey St
Newark, NJ 07101
www.njconsumeraffairs.gov/pc
New Jersey Division of Consumer Affairs
PO Box 45027
124 Halsey St
Newark, NJ 07101
Pennsylvania teletherapy disclosure statement
Welcome
Before you begin receiving teletherapy services from Bend Health, we’d like to share the information below with you, as required by the Pennsylvania Board of Examiners for Social Workers and Professional Counselors. Please read through this document carefully and ask your therapist about information that seems unclear before you begin counseling, or at any time throughout your course of treatment.
Your Rights
As licensed therapists, we desire to integrate sound cognitive behavioral therapy principles in your treatment. You are entitled to receive information from any therapist concerning our methods of therapy, the techniques used, an estimation of the duration of your treatment, risks and benefits of counseling, confidential communication, and access to your records. You also have the right to know what other treatment options are available and the possible effectiveness of those alternatives. You may at any time seek a second opinion from another clinician and/or terminate the counseling process. Therapists need to be informed if you are working with more than one counselor. In a professional relationship with a therapist, sexual intimacy is never appropriate and should be reported to the board that licenses, registers, or certifies that therapist.
HIPAA provides you with several new or expanded rights regarding your Clinical Record and disclosures of protected health information. These rights include requesting that your therapist amend your record; requesting restrictions on what information from your Clinical Record is disclosed to others; requesting an accounting of any disclosures of protected health information that you have neither consented to nor authorized; determining the location to which protected information disclosures are sent; having any complaints you make about our policies and procedures recorded in your records; and the right to another copy of this Notice upon request.
Disclosure of experience, degrees, licensing, and other certifications
You have the right to be informed regarding the degrees, credentials, certifications, registrations, and licenses held or obtained by your therapist. This includes the education, experience and training that were required to satisfy the degrees, credentials, certifications, registrations, and licenses. We have multiple licensed therapists who are working through our teletherapy practice.
This information is required by the Board of Social Workers, Marriage and Family Therapist, and Professional Counselors which regulates social workers, marriage and family therapists and counselors. The board can be contacted at:
State Board of Social Workers, Marriage and Family Therapists and Professional Counselors
P.O. Box 2649
Harrisburg, PA 17105-2649
Phone: (717) 783-1389
Fax: (717) 787-7769
Texas teletherapy disclosure statement
Welcome
Before you begin receiving teletherapy services from Bend Health, we’d like to share the information below with you, as required by the Texas Board of Examiners for Social Workers and Professional Counselors. Please read through this document carefully and ask your therapist about information that seems unclear before you begin counseling, or at any time throughout your course of treatment.
Your Rights
As licensed therapists, we desire to integrate sound cognitive behavioral therapy principles in your treatment. You are entitled to receive information from any therapist concerning our methods of therapy, the techniques used, an estimation of the duration of your treatment, risks and benefits of counseling, confidential communication, and access to your records. You also have the right to know what other treatment options are available and the possible effectiveness of those alternatives. You may at any time seek a second opinion from another clinician and/or terminate the counseling process. Therapists need to be informed if you are working with more than one counselor. In a professional relationship with a therapist, sexual intimacy is never appropriate and should be reported to the board that licenses, registers, or certifies that therapist.
HIPAA provides you with several new or expanded rights regarding your Clinical Record and disclosures of protected health information. These rights include requesting that your therapist amend your record; requesting restrictions on what information from your Clinical Record is disclosed to others; requesting an accounting of any disclosures of protected health information that you have neither consented to nor authorized; determining the location to which protected information disclosures are sent; having any complaints you make about our policies and procedures recorded in your records; and the right to another copy of this Notice upon request.
Disclosure of experience, degrees, licensing, and other certifications
You have the right to be informed regarding the degrees, credentials, certifications, registrations, and licenses held or obtained by your therapist. This includes the education, experience and training that were required to satisfy the degrees, credentials, certifications, registrations, and licenses. We have multiple licensed therapists who are working through our teletherapy practice.
The Texas Behavioral Health Executive Council oversees the Texas State Board of Examiners of Marriage and Family Therapists, the Texas State Board ofExaminers of Professional Counselors, and the Texas State Board of Social Worker Examiners. Any and all complaints related to Texas Licensed Marriage and Family therapists, Licensed Professional Counselors, or Licensed Clinical Social Workers can be directed to:
Texas Behavioral Health Executive Council
333 Guadalupe St, Ste. 3-900
Austin, Texas 78701
Tel. (512) 305-7700
1-800-821-3205 24-hour, toll-free complaint system
Bend Health Texas Therapists
Rosimar Suddeth LCSW – TX License # 39976
It's an honor to be on this path with you as your Bend Health therapist to work with you and your family to help your mental health needs.
