• "Sometimes the bravest and most important thing you can do is just show up." — Brené Brown

  • Information and Forms

  • Consent Form








  • Patient Registration

  • HIPPA Notice

  • Controlled Medications Agreement

  • The confidentiality of all communications between a client and Be staff members are generally protected by law and we here at Be cannot and will not tell anyone else what you have discussed or even that you are in the IOP program without your written permission. In most situations, Be can only release information about your treatment to others if you sign a written Authorization Form that meets certain legal requirements imposed by HIPAA. With the exception of certain specific situations described below, you have the right to confidentiality of your IOP experience. You may request to share information with whomever you choose and you may revoke that permission in writing at any time. For more information, please review the HIPAA Notice of Privacy form. 

  • Insurance companies, managed care, and other third-party payers are given information that they request regarding services to the client. Information which may be requested includes type of services, dates/times of services, diagnosis, treatment plan, description of impairment, progress of therapy, and summaries. When payment for services are the responsibility of the client, or a person who has agreed to providing payment, and payment has not been made in a timely manner, collection agencies may be utilized in collecting unpaid debts. The specific content of the services (e.g., diagnosis, treatment plan, progress notes, testing) should not disclosed. If a debt remains unpaid it may be reported to credit agencies, and the client’s credit report may state the amount owed, the time-frame, and the name of the clinic or collection source.

  • Therapeutic services are most effective when session times are regular and consistent. If you need to cancel or reschedule a session, you must provide at least 48 hours notice. If you miss a session without canceling, or cancel with less than 48 hours notice, you must pay the full fee for the missed session. You are responsible for coming to your session on time. If you are late, your appointment will still end on time.