Forms
If you are a new client, please complete the following forms and bring them to the initial session.
Client Information Form
Information and Consent Form
Forms
If you are a new client, please complete the following forms and bring them to the initial session.
Client Information Form
Information and Consent Form
Russell V. Richard, LCSW
Forms
If you are a new client, please complete the following forms and bring them to the initial session.
Client Information Form
Information and Consent Form
Fees
Payment is due at the time service is rendered. Sessions cost $135 per hour. 50 minutes are dedictated to working with you directly and the remaining 10 minutes are used for documentation and other administrative tasks associated with your care. Cash, checks or credit cards are accepted. You may also submit payment using PayPal by clicking the "Buy Now" button below.
Should you utilize insurance, you may be required to pay a co-pay or a percentage of the cost of the session. Currently I accept the following insurance plans:
*Cigna
*Blue Cross Blue Shield
*Humana
*Value Options
*United Behavioral Health
*United Healthcare
Cancellations
If you are unable to keep a scheduled appointment, please notify me 24 hours in advance. If I do not receive advanced notice you will be required to pay the cost of the session.
Contact
I can be reached at 713-320-7401. It is rare that I am able to answer calls directly so please leave a message and I will respond at my earliest opportunity. Due to time constraints phone calls are generally brief. You may utilize electronic forms of communication such as text messages and email to contact me, however, only for the purposes of scheduling appointments and other logisitical matters. Due to the inability to ensure confidentiality, I prefer to address all matters related to your care in person or by phone. Should we meet publicly I will not initiate contact with you for the purposes of respecting your privacy and maintaining confidentiality.
Forms
If you are a new client, please complete the following forms and bring them to the initial session.
Client Information Form
Information and Consent Form
Forms
If you are a new client, please complete the following forms and bring them to the initial session.
Client Information Form
Information and Consent Form
Confidentiality
Due to the sensitive nature of information disclosed during the course of therapy your privacy is held in high regard. With the exception of certain significant circumstances, any disclosures to third parties will only occur with your written consent. The exceptions to confidentiality are listed below:
*You are a danger to yourself or others.
*You are a minor, elderly, or disabled person and are being
abused.
*You have perpetrated abuse against a minor, elderly or
disabled person.
*You had sexual contact with a previous psychotherapist or
clergy member.
*You file suit against me for breech of duty.
*You use insurance for payment and the insurance company
requests information about your case.
*A court order or other legal proceedings or statute requiring
disclosure.
Terminating Treatment
If at any time during the course of your treatment I determine it is not advisable to continue our work together, I will terminate treatment and explain why this is necessary. Ideally, therapy ends when we agree your treatment goals have been achieved. Additional conditions for termination include the following:
*You have the right to stop treatment any time. If you make
this choice, referrals to other therapists can be provided and
you will be asked to attend a final closure session.
*Other legal or ethical circumstances may arise and compel
me to terminate treatment. In these cases appropriate
referrals will be offered. Also, I do not diagnose, treat or
advise on problems outside the recognized boundaries of my
competencies.
*Other situations that may result in termination include:
regularly becoming enraged or threatening during sessions,
disclosing illegal intentions or actions and frequent or late
arrival to sessions.