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Psychotherapy Services
Agreement Form
The Service Agreement outlines the structure, policies, and expectations for working together. It is designed to promote clarity, transparency, and a shared understanding of how services are provided.
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Selective Private-Pay Practice
Psychotherapy services are provided by Richard Zahn, PsyD, LMFT, a licensed California psychotherapist with advanced training and extensive clinical experience. Services are intentionally limited to ensure depth, quality and individualized care. Psychotherapy is a structured, professional process focused on assessment, treatment planning, and evidence-based intervention. While many clients experience benefit, specific outcomes cannot be guaranteed.
Scope of Practice
Services are provided to adults (age 21 and over) and may occur in person or via telehealth. Dr Zahn provides individual psychotherapy. Coaching services when offered are distinct from psychotherapy and are not insurance-reimbursable. These services are offered by Dr. Zahn through Provisio Coaching.
Services That Are Not Provided
Dr Zahn and Cognitive Therapy Solution do not provide the following services, including but not limited to:
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Psychological testing or formal evaluations
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Including"fit-for-work/duty" or to satisfy work-leave requirements.
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Court-ordered treatment or court-related services of any kind.
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Child custody evaluations Forensic services, reports, depositions, or expert testimony.
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Medi-Cal or Medicare services.
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Treatment for substance use or related issues while the patient is actively using.
Effective therapy requires an appropriate clinical fit. Dr. Zahn reserves the right to determine whether his services are clinically appropriate for client's needs and may refer to other professionals when indicated.
Professional Fit and Selectivity
Fees and Financial Policy
The professional fee is $200 per 50-minute session. Fees are fixed and reflect the nature of a private-pay, specialty practice. Slidingscale rates, reduced fees, or cash discounts are not offered. Services are offered on a private-pay basis and payment is due at the time of service.
A valid credit card is required to be maintained on file for all clients. The card on file is used to process charges for late cancellations or missed appointments, in accordance with the cancellation policy below. This policy reflects the reservation of professional time and the practical limitations of reassigning sessions on short notice.
Dr. Zahn does not participate in insurance networks or Employee Assistance Programs. Upon request, a superbill may be provided for clients seeking outof-network reimbursement. Submission of claims and verification of benefits are the client's responsibility.
Psychotherapy is confidential within the limits of California law. Confidentiality may be breached when legally required, including situations involving suspected abuse, serious risk of harm to self or others, or court order.
Confidentiality and Legal Limits
Scheduling, Attendance, and Cancellation Policy
Appointments are reserved exclusively for each client. Sessions are typically scheduled on a recurring basis to support continuity and progress. A minimum of 48 hours' notice is required to cancel or reschedule an appointment. Appointments cancelled with less than 48 hours' notice, or missed without notice are charged the full session fee and billed to the credit card on file. This policy applies regardless of the reason for the late cancellation or missed session. Visible openings reflect future scheduling availability and do not change the cancellation policy for previously reserved sessions. Insurance does not reimburse for missed or late-cancelled sessions.
Professional Boundaries and Availability
Dr. Zahn maintains clear professional boundaries to ensure effective treatment. Non-urgent messages are returned during business days. Ongoing availability between sessions is not provided, and psychotherapy is not a substitute for emergency services. In the event of an emergency or immediate safety concern, contact 911 or 988 for a mental heath crisis.