PRACTICE POLICIES

Holistic Healing Partners, LLC DBA Milford Med Spa, 99 Cherry Street, Milford, CT, 06460, 203-701-6161

APPOINTMENTS AND CANCELLATIONS

· If you fail to keep your scheduled appointment or neglect to cancel the appointment with at least 48 hours’ notice (unless there is an emergency), you will be charged a fee of $100. This is necessary because a time commitment is made to you and is held exclusively for you.

· Utilizing our waitlist does not waive or override the 48-hour cancellation policy. If you are on a waitlist while holding a confirmed appointment, the original appointment remains subject to the 48-hour cancellation requirement. Accepting an earlier opening within 48 hours does not eliminate or transfer that responsibility.

· If you do not show up for a scheduled appointment or cancel with less than 24 hours’ notice on 2 occasions within the past year, you will be discharged from the practice.

· If you are late for a visit, you may lose some of the time reserved for you.

· Your scheduled treatment may not be able to be completed and you may be charged a late cancellation fee of $100 if you are more than 5 minutes late.

· You must be located in Connecticut for all video visits. This ensures compliance with legal regulations for nurse practitioner licensure.

· Services are by appointment only. It is your responsibility to discuss any medication concerns and request all refills at the time of your visit.

MEDICATION REFILLS

· PRESCRIPTION REFILLS ARE SENT DURING YOUR REGULARLY SCHEDULED APPOINTMENT; therefore, it is particularly important that you keep your appointments and reschedule as soon as possible if you cannot attend. It is possible that your provider may not have an open appointment for 2 to 3 weeks.

· Refills will not be sent between visits, after hours, on weekends or holidays. (meaning we do not respond to refill requests from pharmacies)

· The on-call provider will not answer calls regarding medication refills.

· CONTROLLED SUBSTANCES will not be refilled outside of a visit; you need to be seen at minimum every 3 months for controlled substance prescriptions.

· If you have a preferred medication, you MUST let your provider know prior to them sending the prescription to your pharmacy. For example, if you want a brand name or need a less expensive medication, let your provider know during the visit.

· If you are changing pharmacies, you MUST let your provider know prior to them sending the prescription to your pharmacy on file. Prescriptions will not be resent to another pharmacy outside of a visit.

CRISIS PROCEDURE

In the event of a crisis or emergency, we ask you to please call 911 or go to the nearest emergency room/hospital and get immediate help. If we are currently working with you, in the event of an urgent matter, you may call or text our office number at 203-701-6161 to leave a text or voicemail message to explain the situation; still our office number is NOT TO BE USED FOR SOLVING EMERGENCY CRISIS.

TELEPHONE/TEXT COMMUNICATION

· If you need to contact your provider between visits, you may leave a message on our voicemail or text at 203-701-6161. Messages left at this number are accessible to our office assistants and our licensed health care providers.

· We are often not immediately available; however, we will attempt to return your message within 24 hours. Messages received after hours or on weekends will be answered the next business day.

· We cannot ensure the confidentiality of any form of communication through electronic media, including text messages. If you prefer to communicate via email or text messaging for issues regarding scheduling or cancellations, we will do so. · While we may try to return messages in a timely manner, we cannot guarantee immediate response and request that you do not use these methods of communication to discuss therapeutic content and/or request assistance for emergencies.

· Please note that Face-to-face visits (in person or video) are highly preferable to phone/text contact.

·You agree to receive (you “opt in” to receiving) SMS text messages from our organization related to services that we are providing to you. Message and data rates may apply, and message frequency varies. You may text us STOP at any time to opt out of receiving SMS text messages from us. You may text us HELP at any time to receive help.

SOCIAL MEDIA AND TELECOMMUNICATION

Due to the importance of your confidentiality and the importance of minimizing dual relationships, we do not accept friend or contact requests from current or former patients on any social networking site (Facebook, LinkedIn, etc). We believe that adding patients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up when we meet and we can talk more about it.

PAYMENT FOR SERVICES

Due to rising costs and the amount of time involved in completing and processing services, the following is a list of charges, charged to you (our patients):

No Show or Late Cancellation (less than 48 hours’ notice) $100

Minimum charge for Botox/Dysport/Xeomin/Daxxify visit $200

RETURN POLICY

We do not offer refunds for products or services. ONLY credits with at least 48 hours of cancellation notice.

RECORDS REQUESTS/RETRIEVAL

Connecticut Statute 20-7c allows providers to charge a fee for medical records sent to entities such as law offices, disability claims, and other organizations. The request must be received in writing from the patient, patient’s attorney or authorized representative, or pursuant to a written authorization. The per page fee is $0.65 plus the cost of first-class postage if applicable; however, there is no fee if for the purpose of supporting a claim or appeal under any provision of the Social Security Act and the request is accompanied by documentation of the claim or appeal. While medical records requests will be fulfilled, there is an allowable 30 days to fulfill the written request, per Connecticut statute 20-7c. When a patient requests a copy of the patient’s record for purposes of reviewing current medical care, there is no fee.

TERMINATION

Ending relationships can be difficult. Therefore, it is important to have a termination process in order to achieve some closure. The appropriate length of the termination depends on the length and intensity of the treatment. We may terminate treatment after appropriate discussion with you and a termination process if your provider determines that the treatment is not being effectively used, if you are not following the treatment plan as prescribed, if you are in default on payment, if you have not attended scheduled appointments, if your provider determines that you require services outside their expertise, or if you demonstrate rudeness toward any staff or client. We will not terminate the therapeutic relationship without first discussing and exploring the reasons and purpose of terminating. 

Note: additional practice policy details that you agreed to when entering a provider patient relationship with us are stored in our electronic medical record and may be viewed upon request.