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An online onboarding process is required prior to our first visit.  Please visit the FIRST VISIT INSTRUCTIONS page for this important information. It is required prior to our first appointment.


INITIAL EVALAUTION appointments can last up to 90 minutes.


FOLLOW-UP appointments are generally 30 minutes.

To ensure the highest standard of care, follow-up appointments are regularly scheduled every three months for stable patients.  Complex patients or patients with recent medication changes may require more frequent visits or follow-up appointments within a month after a medication change.


Depending on the medication, I may need you to obtain your vital signs (e.g., blood pressure, weight) in order to prescribe safely. Because my services are often offered by telehealth, you may be required to have certain devices available, such as a blood pressure monitor or scale in order to obtain this information.

Collaboration with your primary care provider or other care providers may be necessary. It may also be helpful to have access to your past and current treatment history. I may request you provide a release of information so that I can discuss relevant issues with your current or past health care providers. I may also request that you provide copies of relevant lab work results and investigative studies (electrocardiograms, CT scans, MRIs, sleep studies, etc.) ordered by other health care providers. This collaboration in care will allow me to provide care in the safest and most efficient way. 


Medications and symptoms will only be discussed during our appointments. Due to the time needed to safely evaluate side effects and symptoms, it would be necessary to discuss medication changes during a scheduled appointment. As such, I will not be able to change/switch medications outside of our appointments. 


Rarely will a patient need refills between appointments. To avoid running out of medications, please monitor your medications and allow up to 5 business days from the time that you request a refill from this office for a medication refill to be processed. 


In the event that a patient has not had an appointment with this office in the last 5 months, no refills will be sent.  Additionally, if you have not scheduled a follow-up appointment, no refills will be sent.

Please be aware that if you are traveling out of Washington state, prescribing laws may vary between states. This office may not be able to send a prescription to that state. Please contact the pharmacy you intend to use while out of state for more information prior to traveling.

Tips when dealing with pharmacies, IF A PROBLEM OCCURS related to refills:


1.  DO NOT use any automated phone system.  It will ask you for a prescription number on your current bottle, If I ordered a refill or changed a dosage, it will not match the number on your old bottle. The system will erroneously tell you that you do not have medications available.  Instead, talk to someone in the pharmacy who can assist you.  If the pharmacy technician can't help, then talk to the pharmacist.

2.  DO NOT talk to a pharmacy technician. Often they are new or temporary workers.  Instead, talk to the pharmacist, as they have more experience with the computer system. 

3.  If a pharmacy technician tells you, " you need a prior authorization", "you need authorization from your doctor", "you don't have approval", "you need approval from your doctor", or " you can't pick it up yet", what they mean is that your insurance company hasn't paid for this medication yet, or there is some insurance issue. The pharmacy technician usually will not elaborate and may attempt to re-direct you to this office.  Again, talk to the pharmacist so that they can explain the situation.  The pharmacist can often resolve the situation.  Often the pharmacy technician doesn't understand the issue or will try to involve an insurance company for a medication that DOES NOT even require insurance reimbursement.  Just avoid this and talk to the pharmacist.

4.  DO look on the bottle to see if there are refills.


My office does not offer consultation via email, phone, or text. However, you may email the office with brief questions.  We may still need to schedule an appointment to customize a treatment if a treatment change is necessary for your situation.

Please note that email is not considered to be a secure form of communication, and by using this form of communication you are accepting the risk that your message may be intercepted or otherwise seen by an unauthorized third party.


Your safety is my priority and duty.


Due to the limited nature of a telehealth only practice, it may be necessary for me to call the police or other emergency personnel in the event of an emergency.


Patients who are in treatment with my practice are receiving care voluntarily, agree to follow through with treatment plans, and are stable enough to receive care in an outpatient setting.  If you are in need of acute treatment services or other treatments that are outside the scope of my solo practice, license, and clinical expertise, I will recommend that you get the necessary care to better serve your needs.

If your symptoms are severe or life-threatening, please get help now. This solo private practice may not be an appropriate fit.  If your condition becomes unstable, medically complex, or could benefit from a specialist setting, I will recommend transferring care so you can get the best care possible.

If you have more than one prescriber for the same types of issues, let's talk about it to better understand why. 


I do not prescribe or refill non-psychiatric medications, including opioids or other types of pain management.


Information discussed during the course of treatment is confidential. By law, information concerning treatment may be disclosed only with the written consent of the person receiving treatment (or person’s guardian if applicable). In the event where there is suspected child or elder abuse or an imminent danger of harm to one’s self or others, the law requires release of confidential information. In these instances, we are required to make a report to the appropriate authorities. In addition, the courts may subpoena treatment records in certain circumstances. Any type of release of confidential information will be discussed with you. However, your insurance company may request records at any time.


We are compliant with the Health Insurance Portability and Accountability Act (HIPAA), a federal law that provides privacy protections and patient rights with regard to personal health information (PHI). HIPAA requires that we provide you with a Notice of Privacy Practices. This Notice, in addition to this agreement, explains HIPAA and its application to your personal health care information.

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