Starkville Counseling Associates Counseling for children, adolescents and adults

Would you like a text or call reminder for your appointments?

Our cancellation policy requires that you cancel your appointment 24 hours in advance to avoid being charged the full session rate. You may call the office (323-5588), text your counselor’s cell phone or email our office manager or your counselor any time to cancel an appointment. When canceling, please indicate when you would like to reschedule your next session. In the event that your counselor has to cancel a session, he or she will notify you promptly. The credit card information you provide below will be used for missed appointment charges only.

Payment for services rendered is expected at each session. Acceptable forms of payment include cash, personal check or money order. We offer access to credit card payments on our website through PayPal. Accounts 60 days past due are subject to referral to an outside collection agency. In the event that your account is forwarded to an external collection agency, all collections fees will be added to your account. Information such as name, social security number, employer, address, and date of birth of the client and/or billing party are released for collection purposes only. My initials indicate permission to release this information if necessary.

I understand that my insurance company may require release of information regarding my treatment, and I authorize the release of such information, if applicable. I understand that I am responsible for any charges not reimbursed by my insurance company. I also authorize SCA to obtain/release/exchange information with my Primary Care Physician, other healthcare practitioner(s) or as requested by my insurance company for the purpose of service coordination and continuity of care.

I understand that my counselor will not willingly testify in any court proceedings as this role, more often than not, jeopardizes the therapeutic relationship. SCA will generally file a motion to quash an attempt to have an SCA counselor participate in a legal matter. All legal fees for SCA representation will be passed on to the client(s) and/or guardian(s) who waive the right to confidentiality and/or legally subpoena an SCA counselor to be deposed or to testify. SCA counselors will charge $1500.00 per day for any scheduled deposition, hearing or courtroom appearance, regardless of the time spent in said activities. This fee applies whether the SCA counselor is able to testify that day or not. Payment for any appearance will be required prior to my counselor’s participating. SCA counselors charge $150.00 an hour for time spent on any additional activities related to any legal matter.