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Wild Nature

Office Policies

  • New Patients
    There will be 1–2 initial visits to ensure proper assessment and thorough evaluation. Your provider will NOT prescribe medication on the first visit. The first appointment (s) is up to 90 minutes, and subsequent appointments will range from 30–60 minutes depending on each person’s needs and preferences. These appointments will be used to evaluate, educate and determine a mental health diagnosis, as well as discuss the side effects and efficacy of your prescribed medication. Your provider may want to see you weekly until either your symptoms are alleviated, or your condition is stabilizing. We will work together to determine the best frequency of appointments going forward based on your health, treatment goals, and stability of your condition. For long-term clients, your provider needs to see you at least every two or three months in order to continue safe and effective management of your medications. For clients who are prescribed stimulants, your provider may need to see you once a month prior to refilling your medication.
  • Care Delivery
    Office hours and provider availability are on Monday, Tuesdays, Wednesdays, and Thursdays from 9:00AM PST to 5:00PM PST. To Schedule an appointment , call our front office 206-800-0593. ​ Treatment will be conducted via Telehealth and/or in-person office visits for your comfort and convenience, so please be aware that your provider may not be able to respond to you until these set times that the provider is in office, before, between and after patient appointments. For after-hours, weekends, or if you need help immediately you should call the crisis clinic at 1.866.4CRISIS (1.866.437.4747). Telehealth services reduce barriers to accessing mental health care, but it limits your provider's ability to assess your vital signs including height, weight, pulse rate, and blood pressure. These are basic indicators of health that may be impacted by your treatment, so it is important to be able to assess these measurements regularly. With that in mind, your provider at Elia Wellness Services requests that each individual treated via telehealth obtain an accurate scale to measure their weight and an automatic sphygmomanometer (blood-pressure monitor) if you do not already own these. Each of these can be purchased for approximately $40. Your provider request that each individual measure and record their weight, pulse, and blood pressure prior to each visit. In private practice, Elia Wellness Services does not have on-call coverage for emergent situations or have assisting prescribers to support emergent needs.
  • Health Monitoring & Collaboration of Care
    At Elia Wellness Services, we request that you provide a release of information (ROI) for your provider to discuss issues relevant to your health and treatment with your primary care provider, psychotherapist or counselor, and all other relevant healthcare providers. We also request that you provide us copies of any relevant lab-work results and investigative studies (electrocardiograms, CT scans, MRIs, sleep studies, etc.) ordered by other health care providers during the course of our therapeutic relationship. This collaboration in care will allow your provider to provide care in the safest and most efficient way.
  • Emergencies
    Distinguishing between an emergency, urgent, and non-urgent request: In the event of an emergency (you feel suicidal, homicidal, or medical emergency), call 911 or go to the closest emergency room. If you have a need for consultation outside of an appointment (medication side effects, increase in symptoms, etc.), please direct your questions to us via the email or phone number listed. Email: Phone: 206-800-0593 ​ Occasionally questions arise in-between visits. If you have a question or concern related to your treatment and need to communicate with your provider between appointments, please contact us via email. We will aim to respond within 72 hours. We work set days Monday through Thursday. We will not be available for emergencies (those which are threatening to life or limb). Examples of emergencies include: having an active intent to end your life, to harm someone else, having auditory hallucinations instructing you to do things, manic symptoms such as impulsivity and high-risk behavior, or an allergic reaction to medication involving swelling in the lips, mouth, or throat. In an emergency such as these please go directly to the nearest emergency department, or contact emergency services to take you to the nearest emergency department. Your provider needs to be informed about these circumstances also, but your provider will not be available to treat these issues outside of appointment times. For urgent issues which cannot wait until your next scheduled appointment, please leave a detailed message on our secure voice mail or email. Examples of urgent issues include: having intolerable side-effects to medication, needing to taper a medication your provider at Elia Wellness Services has provided to you which you’ve been advised to stop using by another of your health-care providers, having run out of medication between visits due to loss, theft or misplacement. Please note: Most clinical issues should be shared in your sessions with your provider.
  • FMLA, Disability & Other Paperwork Requests
    FMLA, disability, and other paperwork requests: patients encounter circumstances in which they find themselves with impairment in their ability to function adequately to meet the requirements of their work. At times it may be appropriate to use FMLA or disability to provide support until the functioning has returned. At Elia Wellness Services, the provider does not complete this paperwork for new patients, with whom the provider does not have an established therapeutic relationship. For individuals requesting this type of assistance, we require that you meet with your provider at Elia Wellness Services, to discuss the specific functional impairments. Please allow 5 business days for the completion of this documentation.
  • Cancellation Policy
    In order to provide you with optimal care, your appointment time is reserved specifically for you. We do not double book clients. In return, we ask that you provide our office with a minimum of 24-hour notice (weekends and holidays do not count) if you are unable to make it to your appointment. Please call our front office staff for all scheduling needs at (206) 800-0593 to ensure prompt attention. If there is a pattern noticed of canceled appointments (whether providing 24-hour notice or not), your provider may be unable to continue to provide services and reserve the right to cancel future appointments in order to make room for clients committed to the therapeutic process. Your provider will always communicate about this with you and determine if you and the provider are a good fit prior to making changes to your scheduled appointments. At Elia Wellness Services, we do understand parenting is difficult and illness occurs, or things happen. Your provider or our staff will make every effort to provide you with adequate notice if your provider will be unavailable for a scheduled appointment and will be more than happy to reschedule as needed.
  • Telehealth Services
    For Telehealth sessions, we will be connecting using a system that is encrypted to the federal standard and HIPAA compatible. It is the provider's responsibility to choose a secure location to interact with technology-assisted media and to be aware that family, friends, employers, co-workers, strangers, and hackers could either overhear our communications or have access to the technology that you are interacting with. Additionally, your provider agrees not to record any Telehealth sessions. During a Telehealth session, you and the provider could encounter a technological failure. The most reliable backup plan is to contact one another via telephone. Your provider will ensure that there is a phone available and that the phone number has been provided to you the client. We understand that all fees for Telehealth and non-Telehealth services are the same. Your provider is financially responsible for all services rendered, late cancellations, and missed appointments.
  • Controlled Substances
    Current legislation (Ryan Haight Online Pharmacy Consumer Protection Act of 2008) prohibits me from prescribing controlled-substances to individuals via Telehealth. Several of these are used commonly in psychiatric care for ADHD, certain types of anxiety disorders, insomnia and to treat side-effects to other therapeutic agents used in this field. For this reason, I do not treat or carry out ADHD testing via Telehealth. If you are looking for standard and first-line treatment for ADHD I recommend in person office visits only. Having said this, there are non-stimulant/non-controlled treatments for ADHD which I do provide, as appropriate, for individuals with ADHD and that can be done via Telehealth. The following is a link to controlled substances that your provider at Elia Wellness Services, do not prescribe via Telehealth: Controlled Substance Schedules ( Examples include hydromorphone (Dilaudid®), methadone (Dolophine®), meperidine (Demerol®), oxycodone (OxyContin®, Percocet®), and fentanyl (Sublimaze®, Duragesic®), morphine, opium, codeine, hydrocodone, amphetamine (Dexedrine®, Adderall®), methamphetamine (Desoxyn®), methylphenidate (Ritalin®), amobarbital, glutethimide, pentobarbital, (Tylenol with Codeine®), buprenorphine (Suboxone®), benzphetamine (Didrex®), phendimetrazine, ketamine, anabolic steroids such as Depo®-Testosterone, alprazolam (Xanax®), carisoprodol (Soma®), clonazepam (Klonopin®), clorazepate (Tranxene®), diazepam (Valium®), lorazepam (Ativan®), midazolam (Versed®), temazepam (Restoril®), and triazolam (Halcion®), (Robitussin AC®, Phenergan with Codeine®), and ezogabine.
  • Financial Responsibility & Insurance Billing Practices
    Payment in full is due at the time of each session including private pay amounts, copays, coinsurance, and deductibles. You will be billed for any remaining balance. Please provide full insurance information and your insurance card upon your initial office visit with your provider at Elia Wellness Services to determine the eligibility of benefits and obtain authorization from your insurance provider when necessary, prior to your first visit. If you have a change in insurance, please let us know as soon as possible, so we can ensure payment. Elia Wellness Services, reserves the right to bill our standard fees for case coordination, clinical and legal write-ups, and phone consultations (school personnel, primary health provider) exceeding 15 minutes per week. Our time is valuable and is best served by providing high-quality professional services to you while you are here in session. There is no charge for routine telephone calls to Elia Wellness Services administrative staff regarding scheduling, appointments, or billing.
  • Confidentiality
    The information discussed during the course of therapy is confidential. By law, information concerning your treatment may be released only with the consent of the person treated (or the person's guardian if applicable). In the event where there is suspected child abuse, neglect, exploitation (RCW 26.44), or imminent danger of harm to one's self or others, the law requires the 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. 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 care information (PHI). HIPAA requires that we provide you with a Notice of Privacy Practices. This Notice, which is attached to this agreement, explains HIPAA in detail and its application to your personal health care information.
  • Notice of Privacy Practices
    Your Information - Your Rights - Provider Responsibilities. Please review carefully. Under Washington Administrative Code (WAC) 388-877-0600, you have the right to: Receive services without regard to race, creed, national origin, religion, gender, sexual orientation, age to disability. Practice the religion of choice as long as the practice does not infringe on the rights and treatment of others or the treatment service. Individual participants have the right to refuse participation in any religious practice. Be reasonably accommodated in case of sensory or physical disability, limited ability to communicate, limited English proficiency, and cultural differences. Be treated with respect, dignity, and privacy, except that staff, may conduct reasonable searches to detect and prevent possession or use of contraband on the premises. Be free of any sexual harassment. Be free of exploitation, including physical and financial exploitation. Have all clinical and personal information treated in accordance with state and federal confidentiality regulations. Review your clinical record in the presence of the administrator or designee and be given an opportunity to request amendments or corrections. Receive a copy of agency grievance system procedures upon request and file a grievance with the agency, or behavioral health organization (BHO), if applicable, if you believe your rights have been violated. Lodge a complaint with the Washington State Department of Health when you feel the agency has violated a WAC requirement regulating behavior health agencies. Washington State-Department of Health Health Systems Quality Assurance (HSQA)-Complaint Intake P.O. box 47857 Olympia, WA 98504-7857 email:
  • Responsibilities as Your Clinician and Safety Referral
    Your provider at Elia Wellness Services, is required by law to maintain the privacy and security of your protected health information. Your provider will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. Your provider must follow the duties and privacy practices described in this notice and give you a copy. Your provider will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let our office know in writing if you change your mind. For more information see: Email/Text Consultations At Elia Wellness Services, we do not offer consultations via email, phone, or text. While you may email brief questions or concerns, an appointment may still be required for any treatment adjustments. Although our emails are HIPAA-protected, we cannot guarantee the security of the patient's email service. Please be aware that email is not a secure form of communication and carries the risk of unauthorized access. Safety Referral (Scope-of-practice and Limitations) At Elia Wellness Services, your safety is our priority. Due to the limitations and operational hours of our practice, it may be necessary to contact emergency services in the event of an emergency. Patients receiving care from our outpatient clinic do so voluntarily, agree to follow treatment plans, and are stable enough for outpatient care. If you require acute treatment services or care beyond the scope of our practice at Elia Wellness Services, your provider will recommend appropriate services to meet your needs. If your symptoms are severe or life-threatening, please seek immediate help. Our outpatient practice may not be suitable for medically complex or unstable conditions, and your provider will recommend transferring care to ensure you receive the best possible treatment. If you have multiple prescribers for the same issues, please discuss this immediately with your provider so we can better understand and manage your care effectively. Failure to share this critical information and/or continuing to see multiple providers for the same issues may result in discharge from our care. Having more than one prescribing provider can lead to several potential issues that compromise patient safety and treatment efficacy. Here are some key reasons: 1. Risk of Medication Errors and Adverse Drug Interactions: Multiple providers prescribing medications without coordination can result in unintended drug interactions and duplicate therapies. This increases the risk of adverse effects and can compromise the efficacy of treatment plans. 2. Lack of Comprehensive Patient History: When patients have multiple prescribing providers, no single provider may have a complete understanding of the patient's medical history, medications, and treatment plans. This can lead to suboptimal care and mismanagement of health conditions. 3. Fragmented Care: Coordination among multiple providers can be challenging, leading to fragmented care. This fragmentation can result in inconsistencies in treatment approaches and a lack of accountability for patient outcomes. 4. Patient Safety Concerns: A single prescribing provider can closely monitor a patient's response to medications and make necessary adjustments. When multiple providers are involved, this continuous monitoring is disrupted, potentially jeopardizing patient safety. 5. Regulatory and Compliance Issues: Healthcare regulations often emphasize the importance of coordinated care to ensure patient safety and compliance with treatment protocols. Having multiple prescribing providers can complicate adherence to these regulations. To ensure optimal patient care, it is crucial to have a single prescribing provider who can oversee and coordinate all aspects of a patient's medication management. This approach helps to mitigate risks, improve treatment outcomes, and enhance overall patient safety. Refills & Medication Change Requests Medications and symptoms will be addressed exclusively during scheduled appointments. Due to the time required to safely evaluate side effects and symptoms, any changes to medications must be discussed during an appointment. I am unable to make medication changes outside of these scheduled visits. Refills between appointments are rarely necessary. To avoid running out of medications, please monitor your supply and allow up to five business days for refill requests to be processed by this office. If you have not had an appointment within the last two to three months, no refills will be issued. Additionally, if you do not have a follow-up appointment scheduled, refills will not be provided. Please note that prescribing laws may vary between states. If you are traveling out of Washington state, this office may not be able to send a prescription to your destination. Contact the pharmacy you intend to use while out of state for more information prior to traveling. Tips for Dealing with Pharmacy Issues Related to Refills: 1. Avoid Automated Phone Systems. These systems often require a prescription number that may not match if a refill or dosage change was ordered. Speak directly with a pharmacy staff member instead. 2. Speak to the Pharmacist. Pharmacy technicians may be new or temporary. The pharmacist has more experience with the system and can provide better assistance. 3. Avoid unsolicited medical advice from pharmacy technicians. Some patients have encountered significant issues when pharmacy technicians have provided inaccurate prescription information or unnecessary medical advice regarding a prescription. Pharmacy technicians typically do not have a medical background. In psychiatry, a single medication may be prescribed to treat multiple conditions, and your provider has the expertise to determine the appropriate treatment. If you need further information or clarification regarding your prescription, please speak directly to the pharmacist or refer to your provider. 4. Clarify Insurance Issues. If you are told you need authorization or approval, this typically means there is an insurance issue. The pharmacist can often resolve these situations more effectively than a technician. 5. Check for Refills on Your Bottle. Ensure there are refills remaining on your current prescription bottle.
  • Respond to Lawsuits & Legal Actions
    Your provider can share health information about you in response to a court or administrative order, or in response to a subpoena. If there will be sharing of your health information, your provider will provide a Release of Information to request specific information and with whom for you to sign consent.
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