Good Faith Estimate and extra policies

What is a Good Faith Estimate?

If you are paying out of pocket (not using insurance), you have the right to receive a Good Faith Estimate (GFE) outlining the expected cost of your therapy.

A Good Faith Estimate includes:

Describes the type of services we’re planning (for example, weekly 50‑minute sessions)
Outlines the estimated total cost over a period of time (for example, 3–6 months)
Is provided in writing before we begin ongoing therapy

This is an estimate, not a contract. If we adjust your treatment plan—such as meeting more or less often—I will update the estimate to reflect our new agreement.

Under the No Surprises Act, if your actual charges are significantly higher than the estimate, you may have the right to dispute the bill. This law is designed to promote transparency, so you can make informed decisions about your care.

What are your fees?

*Ongoing 50‑minute session: $250 per 50-minute individual session (telehealth) for individuals, couples, and families. $300 per 50-minute in-person session (only in San Diego, CA). Students (current full‑time with valid ID): $200 per 50‑minute session (telehealth); $250 per 50-minute session in person, only in San Diego, CA.

If fees ever need to change, I will let you know in advance and we can talk about what feels sustainable for you.

Do you take insurance?

I do not accept insurance at this time, so all services are self‑pay, and payment is due at the time of service. Many clients choose to use HSA/FSA funds or check with their insurance provider about possible out‑of‑network benefits. I’m happy to answer any questions about fees and payment so you can make an informed decision before we begin.

You can call your insurance and ask about “out-of-network mental health benefits” to understand what’s covered.

How do payments work?

Payment is due at the time of each session
I accept the following forms of payment: Major credit cards: Visa, MasterCard, American Express, and Discover. Also, Cash, Apple Pay, Venmo, PayPal, and Zelle. Checks and debit cards without a credit card feature are not accepted.
No Surprises Act: You have the right to receive a Good Faith Estimate of what your services may cost.

What is your cancellation policy?

To keep my schedule stable and respectful for all clients:

Sessions canceled or rescheduled more than 24 hours in advance: no fee

Sessions canceled within 24 hours or no‑shows: may be charged the full session fee

I understand that life happens. If there is an emergency or situation outside your control, please let me know—we can talk about how to handle it.

How long are sessions, and how often will we meet?

Standard sessions are 50 minutes
We typically begin with weekly sessions, then adjust as needed

We’ll decide the frequency together, based on your needs, goals, and capacity, and we can revisit this anytime.

Is therapy confidential?

Yes, with important legal and ethical exceptions.

In general, what you share in therapy stays between us. I may need to break confidentiality if:

You are at imminent risk of seriously harming yourself or someone else
There is suspected abuse or neglect of a child, older adult, or vulnerable person
I am ordered by a court to release information

We’ll review these limits at the start of our work so you know exactly what to expect and can ask any questions.

What about privacy for telehealth sessions?

For online sessions, I use a HIPAA‑compliant video platform.

To protect your privacy:

I recommend joining sessions from a private, quiet space
Using headphones can help keep your side of the conversation more confidential

If telehealth is not feeling private or safe for you, we can explore alternatives if available (e.g., in‑person options, scheduling at different times, etc.).

What if I’m in crisis or need immediate help?

I am not able to provide 24/7 crisis services.

If you are in crisis, considering harming yourself or someone else, or feel you cannot stay safe:

Call 911 (or your local emergency number)

Go to the nearest emergency room

Call a crisis hotline, such as:

988 Suicide & Crisis Lifeline (U.S.) – dial 988

You can let me know what’s happened when you’re able, and we’ll talk about ongoing support, but I may not be reachable in the moment of crisis.

The Resource Vault

You don’t have to do it all alone.

Whether you’re looking for a therapist, navigating a tough season, or just trying to hold it together this space is for you.

Inside, you’ll find journaling prompts, mental health resources, and guided tools to help you reset and reconnect especially on the hard days.

If You’re Looking for Additional Support:

Who to call if you need immediate help:

24-hour Crisis Line: National Suicide Prevention Lifeline 988

Sexual Assault Hotline 800-656-4673

Teen Crisis Hotline (800) 448-3000

National Youth Crisis Hotline (800) 442-HOPE (4673)

National Domestic Violence Hotline 1-800-799-7233

Additional Resources

National Alliance on Mental Illness

National Suicide Prevention Lifeline

Terms Of Service

These terms of service outline the rules and regulations for the use of Clare Johnson Therapy's Website.

By accessing this website, we assume you accept these terms of service in full. Do not continue to use Clare Johnson Therapy's website if you do not accept all of the terms of service stated on this page.

The following terminology applies to these Terms of Service, Privacy Statement and Disclaimer Notice, and any or all Agreements: "Client", "You" and "Your" refers to you, the person accessing this website and accepting the Company's terms of service. "The Company", "Ourselves", "We", "Our" and "Us", refers to our Company. "Party", "Parties", or "Us", refers to both the Client and ourselves or either the Client or ourselves. All terms refer to the offer, acceptance, and consideration of payment necessary to undertake the process of our assistance to the Client in the most appropriate manner, whether by formal meetings of a fixed duration, or any other means, for the express purpose of meeting the Client's needs in respect of provision of the Company's stated services/products, in accordance with and subject to, prevailing law of. Any use of the above terminology or other words in the singular, plural, capitalization and/or he/she or they, are taken as interchangeable and therefore as referring to same.

Content Liability

We shall have no responsibility or liability for any content appearing on your Website. You agree to indemnify and defend us against all claims arising out of or based upon your Website. No link(s) may appear on any page on your Website or within any context containing content or materials that may be interpreted as libelous, obscene, or criminal, or which infringes, otherwise violates, or advocates the infringement or other violation of, any third-party rights.

Disclaimer

To the maximum extent permitted by applicable law, we exclude all representations, warranties and conditions relating to our website and the use of this website (including, without limitation, any warranties implied by law in respect of satisfactory quality, fitness for purpose and/or the use of reasonable care and skill). Nothing in this disclaimer will:

limit or exclude our or your liability for death or personal injury resulting from negligence;

limit or exclude our or your liability for fraud or fraudulent misrepresentation;

limit any of our or your liabilities in any way that is not permitted under applicable law; or

exclude any of our or your liabilities that may not be excluded under applicable law.

The limitations and exclusions of liability set out in this Section and elsewhere in this disclaimer: (a) are subject to the preceding paragraph; and (b) govern all liabilities arising under the disclaimer or in relation to the subject matter of this disclaimer, including liabilities arising in contract, in tort (including negligence) and for breach of statutory duty.

To the extent that the website and the information and services on the website are provided free of charge, we will not be liable for any loss or damage of any nature.

Privacy Policy

Richard De La Garza respects your privacy and is committed to protecting any personal information you provide through our website. This Privacy Policy explains what information we collect, how we use it, and your choices regarding your data.

1. Information Collection

Personal Information: We may collect information that you voluntarily provide, such as your name, email address, phone number, and any other details shared through contact forms, consultations, or booking requests.

Non-Personal Information: We may automatically collect non-identifiable information through cookies and similar technologies to analyze website traffic, improve user experience, and monitor usage trends. This may include IP addresses, browser types, and the pages you visit.

2. Use of Information

To Provide Services: Information you provide may be used to respond to inquiries, schedule consultations, and communicate with you regarding therapy services.

To Improve User Experience: Non-personal information helps us improve website functionality, optimize user experience, and ensure that our services are accessible.

Marketing Communications: If you subscribe to updates, we may send you relevant content and resources. You may opt-out at any time by following the unsubscribe link in any email.

3. Cookies and Tracking Technologies

Our website uses cookies to remember preferences, enhance user experience, and collect usage data. You can modify your browser settings to control cookie usage; however, please note that disabling cookies may impact your browsing experience.

4. Third-Party Services

We may work with third-party providers (e.g., analytics services or appointment scheduling platforms) that may access or process data on our behalf. These providers are bound by their own privacy policies, and we recommend reviewing them separately.

5. Data Security and Storage

Clare Johnson Therapy takes reasonable precautions to protect your personal data against unauthorized access, disclosure, alteration, or destruction. However, we cannot guarantee complete security of internet-based data transmissions.

6. Your Rights

Depending on your location, you may have the right to access, correct, delete, or restrict the processing of your personal data. To exercise these rights, please contact us at the email below.

7. Changes to This Policy

We may update our Privacy Policy periodically. Any changes will be posted on this page, and the “Last Updated” date will be adjusted. We recommend checking this page regularly for updates.

8. Contact Us

If you have any questions, concerns, or requests regarding this Privacy Policy, please contact us at delagarzarichard.com

HIPPA Policy

Protecting your private information is of paramount importance to us

By using this site, you agree to this NOTICE of PRIVACY PRACTICES.

I. THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

II. WE HAVE A LEGAL DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION (PHI)

I am legally required to protect the privacy of your PHI, which includes information that can be used to identify you that I’ve created or received about your past, present, or future health or condition, the provision of health care to you, or the payment of this health care. we must provide you with this Notice about my privacy practices, and such Notice must explain how, when, and why we will “use” and “disclose” your PHI.

A “use” of PHI occurs when we share, examine, utilize, apply, or analyze such information within my practice; PHI is “disclosed” when it is released, transferred, has been given to, or is otherwise divulged to a third party outside of my practice. With some exceptions, we may not use or disclose any more of your PHI than is necessary to accomplish the purpose for which the use or disclosure is made. And, we am legally required to follow the privacy practices described in this Notice.

However, we reserve the right to change the terms of this Notice and my privacy policies at any time. Any changes will apply to PHI on file with me already. Before we make any important changes to my policies, we will promptly change this Notice and post a new copy of it in my office and on my website. You can also request a copy of this Notice from me, or you can view a copy of it in my office.

III. HOW we MAY USE AND DISCLOSE YOUR PHI

I will use and disclose your PHI for many different reasons. For some of these uses or disclosures, we will need your prior written authorization; for others, however, we do not. Listed below are the different categories of my uses and disclosures along with some examples of each category.

Uses and Disclosures Relating to Treatment, Payment, or Health Care Operations Do Not Require Your Prior Written Consent. we can use and disclose your PHI without your consent for the following reasons:
For Treatment. we can use your PHI within my practice to provide you with mental health treatment, including discussing or sharing your PHI with my supervisor. we can disclose your PHI to physicians, psychiatrists, psychologists, and other licensed health care providers who provide you with health care services or are involved in your care. For example, if a psychiatrist is treating you, we can disclose your PHI to your psychiatrist to coordinate your care.
To Obtain Payment for Treatment. we can use and disclose your PHI to bill and collect payment for the treatment and services provided by me to you. For example, we might send your PHI to your insurance company or health plan to get paid for the health care services that we have provided to you. we may also provide your PHI to my business associates, such as billing companies, claims processing companies, and others that process my health care claims.
For Health Care Operations. we can use and disclose your PHI to operate my practice. For example, we might use your PHI to evaluate the quality of health care services that you received or to evaluate the performance of the health care professionals who provided such services to you. we may also provide your PHI to my accountant, attorney, consultants, or others to further my health care operations.
Patient Incapacitation or Emergency. we may also disclose your PHI to others with-out your consent if you are incapacitated or if an emergency exists. For example, your consent isn’t required if you need emergency treatment, as long as we try to get your consent after treatment is rendered, or if we try to get your consent but you are unable to communicate with me (for example, if you are unconscious or in severe pain) and we think that you would consent to such treatment if you were able to do so.

Certain Other Uses and Disclosures Also Do Not Require Your Consent or Authorization. we can use and disclose your PHI without your consent or authorization for the following reasons:
When federal, state, or local laws require disclosure. For example, we may have to make a disclosure to applicable governmental officials when a law requires me to report information to government agencies and law enforcement personnel about victims of abuse or neglect.
When judicial or administrative proceedings require disclosure. For example, if you are involved in a lawsuit or a claim for workers’ compensation benefits, we may have to use or disclose your PHI in response to a court or administrative order. we may also have to use or disclose your PHI in response to a subpoena.
When law enforcement requires disclosure. For example, we may have to use or disclose your PHI in response to a search warrant.
When public health activities require disclosure. For example, we may have to use or disclose your PHI to report to a government official an adverse reaction that you have to a medication.
When health oversight activities require disclosure. For example, we may have to provide information to assist the government in conducting an investigation or inspection of a health care provider or organization.
To avert a serious threat to health or safety. For example, we may have to use or disclose your PHI to avert a serious threat to the health or safety of others. However, any such disclosures will only be made to someone able to prevent the threatened harm from occurring.
For specialized government functions. If you are in the military, we may have to use or disclose your PHI for national security purposes, including protecting the President of the United States or conducting intelligence operations.
To remind you about appointments and to inform you of health-related benefits or services. For example, we may have to use or disclose your PHI to remind you about your appointments, or to give you information about treatment alternatives, other health care services, or other health care benefits that we offer that may be of interest to you.

Certain Uses and Disclosures Require You to Have the Opportunity to Object.
Disclosures to Family, Friends, or Others. we may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.
Other Uses and Disclosures Require Your Prior Written Authorization. In any other situation not described in sections III A, B, and C above, we will need your written authorization before using or disclosing any of your PHI. If you choose to sign an authorization to disclose your PHI, you can later revoke such authorization in writing to stop any future uses and disclosures (to the extent that we haven’t taken any action in reliance on such authorization) of your PHI by me.

IV. WHAT RIGHTS YOU HAVE REGARDING YOUR PHI

You have the following rights with respect to your PHI:

The Right to Request Restrictions on My Uses and Disclosures. You have the right to request restrictions or limitations on my uses or disclosures of your PHI to carry out my treatment, payment, or health care operations. You also have the right to request that we restrict or limit disclosures of your PHI to family members or friends or others involved in your care or who are financially responsible for your care. Please submit such requests to me in writing. we will consider your requests, but we am not legally required to accept them. If we do accept your requests, we will put them in writing and we will abide by them, except in emergency situations. However, be advised, that you may not limit the uses and disclosures that we am legally required to make.
The Right to Choose How we Send PHI to You. You have the right to request that we send confidential information to you to at an alternate address (for example, sending information to your work address rather than your home address) or by alternate means (for example, e-mail instead of regular mail). we must agree to your request so long as it is reasonable and you specify how or where you wish to be contacted, and, when appropriate, you provide me with information as to how payment for such alternate communications will be handled. we may not require an explanation from you as to the basis of your request as a condition of providing communications on a confidential basis.
The Right to Inspect and Copy of Your PHI. In most cases, you have the right to inspect and copy the PHI that we that we have on you, but you must make the request to inspect and copy such information in writing. If we don’t have your PHI but we know who does, we will tell you how to get it. we will respond to your request within 30 days of receiving your written request. In certain situations, we may deny your request. If we do, we will tell you, in writing, my reasons for the denial and explain your right to have my denial reviewed. If you request copies of your PHI, we will charge you not more than $.25 for each page. Instead of providing the PHI you requested, we may provide you with a summary or explanation of the PHI as long as you agree to that and to the cost in advance.
The Right to Receive a List of the Disclosures we Have Made. You have the right to receive a list of instances, i.e., an Accounting of Disclosures, in which we have disclosed your PHI. The list will not include disclosures made for my treatment, payment, or health care operations; disclosures made to you; disclosures you authorized; disclosures incident to a use or disclosure permitted or required by the federal privacy rule; disclosures made for national security or intelligence; disclosures made to correctional institutions or law enforcement personnel; or, disclosures made before April 14, 2003.I will respond to your request for an Accounting of Disclosures within 60 days of receiving such request. The list we will give you will include disclosures made in the last six years unless you request a shorter time. The list will include the date the disclosure was made, to whom the PHI was disclosed (including their address, if known), a description of the information disclosed, and the reason for the disclosure. we will provide the list to you at no charge, but if you make more than one request in the same year, we may charge you a reasonable, cost-based fee for each additional request.
The Right to Amend Your PHI. If you believe that there is a mistake in your PHI or that a piece of important information is missing, you have the right to request that we correct the existing information or add the missing information. You must provide the request and your reason for the request in writing. we will respond within 60 days of receiving your request to correct or update your PHI. we may deny your request in writing if the PHI is (i) correct and complete, (ii) not created by me, (iii) not allowed to be disclosed, or (iv) not part of my records.My written denial will state the reasons for the denial and explain your right to file a written statement of disagreement with the denial. If you don’t file one, you have the right to request that your request and my denial be attached to all future disclosures of your PHI. If we approve your request, we will make the change to your PHI, tell you that we have done it, and tell others that need to know about the change to your PHI.
The Right to Receive a Paper Copy of this Notice. You have the right to receive a paper copy of this notice even if you have agreed to receive it via e-mail.

V. HOW TO COMPLAIN ABOUT OUR PRIVACY PRACTICES

f you think that we may have violated your privacy rights, or you disagree with a decision we made about access to your PHI, you may file a complaint with the person listed in Section Vl below. You also may send a written complaint to the Secretary of the Department of Health and Human Services at 200 Independence Avenue S.W., Washington, D.C. 20201. we will take no retaliatory action against you if you file a complaint about my privacy practices.

VI. PERSON TO CONTACT FOR INFORMATION ABOUT THIS NOTICE OR TO COMPLAIN ABOUT MY PRIVACY PRACTICES

If you have any questions about this notice or any complaints about my privacy practices, or would like to know how to file a complaint with the Secretary of the Department of Health and Human Services, please contact me at: 843.212.1363.

VII. EFFECTIVE DATE OF THIS NOTICE

This notice went into effect on August 19th, 2013.

New HIPAA (health insurance portability and accountability act) privacy standards were created to protect patients’ health information when it is disclosed but also to facilitate the flow of medical information between providers. With other medical providers and for safety or security reasons, there is less protection of confidentiality than there used to be. However, in other areas, there is more privacy protection. Please read the following so that you understand your rights as a patient as well of the new rules about patient confidentiality. Feel free to ask about privacy, confidentiality, or psychiatric records.

Permission from the patient is no longer required for transfer of psychiatric and medical information between providers as long as only the necessary information is supplied. This means that if your primary care doctor, pharmacist, or an emergency room physician calls to find out if you (or your child) are in treatment, what the diagnosis is, or what medications you (or your child) are on, we can convey this information if it is medically relevant to your (or your child’s) treatment with them. In practice, we will almost always discuss this with you personally before or after the fact, depending on the urgency and depth of the request. If you think this might present a problem for you let us know ahead of time.

Remember that if all the psychiatric records are requested, a treatment summary is usually given instead, except if the treatment consists solely of psychopharmacological treatment or brief medication visits. While brief medication visits fall under HIPAA guidelines, psychotherapy visits are specifically excluded, meaning authorization from the patient is still required for release of information in those notes and a summary is given in place of the record.

The substance abuse records from alcohol and drug programs are exempt from any disclosure with outpatient permission. If you (or your child) are admitted to a treatment program for substance abuse be sure to sign a release so that we can talk to the providers and obtain a discharge summary and lab data upon discharge. Without this we cannot obtain any information.

We may have to disclose some psychiatric information when required to do so by law without your consent. This includes mandated reporting of child/elder abuse and cases of legal order or subpoena.

National security and public health issues. We may be required to disclose certain information to military authorities or federal health officials if it is required for lawful intelligence, public health safety, or public security.

BY USING THIS SITE, YOU ACKNOWLEDGE HAVING READ THIS HIPAA FORM AND THE INFORMATION PROVIDED.

How do I know if therapy is right for me?

This is an important question, and there’s no single right path to healing. People seek care, growth, and change through many different routes, influenced by their culture, community, access to resources, and lived experiences. In some places, therapy is a familiar and openly discussed option; in others, it may feel distant, unnecessary, or even inaccessible. None of these perspectives are inherently “right” or “wrong”—they’re simply shaped by context.

I practice therapy because it has been a meaningful, liberating process in my own life, and I continue to see how transformative it can be when people are met with curiosity, respect, and collaboration. In my approach, therapy isn’t about fixing you or telling you who to be. Instead, it’s a shared space for reflection and action—where we explore what you’re carrying, where those experiences come from, and what kinds of change might feel possible and meaningful for you.

Therapy may be helpful if you’re experiencing ongoing sadness, anxiety, stress, or disconnection that makes daily life more difficult. It can also support you as you navigate transitions, relationships, questions about identity, or a desire for deeper self-understanding. Therapy is also a place to build skills, strengthen boundaries, and reconnect with your sense of agency and dignity.

If you’re curious, a consultation is simply a conversation. It’s a chance for us to reflect on what you’re experiencing, what kind of support you’re seeking, and whether therapy—and my approach—feel right for you at this time. You remain the expert on your life; my role is to walk alongside you as we think, feel, and move forward together.