1620 S. 70th St. Suite 101 Lincoln, NE

Fax 402.904.4905

mental health therapy & Medication


Regarding Telehealth with Michelle, Kelly and David... 

We are using Simple Practice for Telehealth Outpatient Mental Health Therapy.  

Please send us a quick email stating that you've read and agree to the 

Consent to Use Telehealth below.  Our emails are located on our individual pages.

We are all in this together. 

~Michelle & Kelly


“Telehealth” or “teletherapy” is defined to be the mode of delivering health care services

(psychotherapy) via information and communication technologies (e.g. phone or internet) to

facilitate the diagnosis, consultation, treatment, education, care management, and self-

management of a patient’s health care while the patient is at the originating site (where you are currently residing) and the health care provider is at a distant site (where the therapist is residing).

You should be aware that providing therapy in this manner has its drawbacks:

* The connection may not be stable. Video can freeze, audio can be dropped, the connection may go black, and if you are in a state of crisis (considering self-harm or suicide), losing the connection would be very bad. A wired connection to your mobile device is ideal, but if you must go wireless, it should be a very strong connection. The therapist can terminate a telehealth session if it is determined that a stable telecommunication connection cannot be adequately maintained.

* Your computer may have problems that preclude a telehealth session. You are strongly

encouraged to make sure you have the latest operating system and security updates, including installation of current and up-to-date antivirus and internet security software, installed on the computer or smartphone you want to use for telehealth sessions. Again, the therapist can terminate a telehealth session if it is determined that a stable telecommunication connection cannot be adequately maintained.

* The session may not be secure or confidential unless you make it so. 

The therapist will be located in a private space for your security and confidentiality, 

so it is encouraged that you locate yourself in a place that you know is private and secure. Therefore, initiating a session at the beach, a park, Denny’s, or Starbucks is neither private, confidential, nor secure.

* Crisis support services may not be available where you are currently residing or in your

geographic area. If you are in a state of crisis and you have no place to get help, there is little a

therapist can do from across the wire. The therapist is responsible for identifying resources in your area based on your address (assuming you have one), but it is entirely up to you to access and utilize those resources.

* There is a lot a therapist CANNOT see during a telehealth session. From a tiny,fteen-inch, 

two-dimensional image, there is significant information that a therapist can miss. Noteworthy mannerisms, gestures, body language or expression, physical appearance, grooming, appropriateness of dress are just a few marks of data that can be missed in a telehealth session.

This information could be very helpful to your progress in treatment.

But don’t despair, there are advantages to using telehealth as a medium for therapy services:

* Therapy from your living room sofa? How awesome is that? You’ll love it so much, you’ll never miss a session. But if you miss two in a row, you will be dropped from the calendar.

* You can schedule sessions around your work schedule.

* Sessions can be conveniently scheduled around the needs of children or loved ones.

* Even if you’re not feeling up to going to an office, you can still attend a session from your home.

* You don’t necessarily have to see a therapist in your local area, but the therapist must be located in the state in which you reside.

Also, be aware that there are assurances you can expect to receive from your therapist in a

telehealth session:

* The therapist will be situated in a location that ensures your session will be secure, confidential and private.

* The therapist will be using a wired network connection to the internet for optimal stability in connectivity to your session.

* The telehealth medium over which the session will occur will meet federal (HIPAA) requirements for security and confidentiality.

* All laws regarding the confidentiality of healthcare information and a patient's right to their

medical information also apply to telehealth interactions.

* With the provision of your address, the therapist will locate resources to help you in the event of a crisis.

* You can use your health insurance benets to pay for telehealth sessions, unless stated otherwise in your policy.

*I understand the drawbacks and disadvantages of using

telehealth as a mode of psychotherapy and men

I understand the advantages of using telehealth as a mode of

psychotherapy and mental health treatment.

* I have read and I understand the advantages and disadvantages of using

telehealth for my mental health/psychotherapy treatment. I agree and consent to

the use of telehealth for the treatment of my mental health concerns. I am aware,

however, that the therapist can decide to terminate telehealth sessions if it is

determined that consistent audio and video connectivity cannot be maintained

*I consent to sharing information provided her.  I also understand that the therapist may decide to terminate telehealth sessions if it is determined that my condition, problem, or situation requires a level of care that is unsuitable for a telehealth mode of psychotherapy.

After reading this please send an email stating: "I read the CONSENT TO USE TELEHEALTH that I read on the Lincoln Therapy website and I consent to it's contents."