Consent for Treatment
This is a binding contract and required before we can provide treatment services. Please read carefully and sign at the bottom. If you have any questions or concerns about these rules, please speak with your Therapist or our Team. We are all here to help you succeed.
I understand that during treatment I must:
- Be alone in a private room with door closed (and locked if possible)
- Always be on video and use a headset
- Instruct others in my house that I cannot be interrupted
Personal Privacy & Anonymity
I understand that all Members have the right to personal privacy and anonymity.
Members are not allowed to share last names, location, emails or phone numbers during open group sessions.
Respect for Other Member’s Beliefs
I will respect other Member’s beliefs and refrain from making inappropriate comments in reference to their opinions, habits, culture, ethnicity, religion or gender.
Timeliness and Attendance
I will attend every group and individual session and will be on time. If I need to miss, I will notify my Therapist or Member Care in advance. Group sessions cannot be rescheduled. I understand that there will be no refunds for sessions missed.
I will complete all homework assignments and work on my Treatment Plan goals between sessions.
I will apply the “intentional tools” during the week and report my experiences during coaching sessions.
Alcohol and Drug Testing
I consent to random drug and alcohol testing during the program.
Conditions of my treatment require abstinence from all drug and alcohol use for the entire duration of the treatment program. If I am unable to make this commitment, I will discuss alternative treatment with my Therapist.
All treatment is voluntary
If I decide to terminate treatment, I will discuss this decision with my Therapist before leaving.
Non-Acceptable Behavior and Early Discharge
I understand that inappropriate behaviors are not acceptable and may result in early termination of my treatment without refund of payments made.
Alcohol & Illegal Drugs
I understand that the use of alcohol and illegal drugs during sessions by me or anyone attending a conjoint session with me is strictly prohibited.
Violent and Disruptive Behavior
I will not make threats of violence or demonstrate violence towards any member of my group, my Therapist, Coach, Mentor or Recovery Help staff.
I will immediately change any behavior my therapist or coach believes is disruptive or is not constructive or positively contributing to the Group; or will agree to leave the session.
Involvement with other Members
I agree not to become involved romantically or sexually with other Members. I agree to not become involved in any business transactions with other Members during treatment with Recovery Help.
There may be unforeseen physical, psychiatric, or psychological difficulties that interfere with my ability to function adequately.
If my Therapist determines that I am unable to benefit from the program due to personal or program limitations.
Failure to Cooperate
Failure by Members to cooperate in meeting treatment goals including non-compliance with your substance abuse plan.
Non-payment of fees by myself, my insurance company or another third party.
Acceptable Use Policy for Recovery Help Electronic Systems
- Do not share passwords to Recovery Help online websites or systems.
- Your personal email may not securely transmit (encrypted) your Protected Health Information (PHI) to Recovery Help. Use the company online systems to request reports or transmit PHI.
- As you use the online video and chat systems, do not put yourself at risk by inappropriately sharing your personal and contact information with other Members or your group.
By signing below, I acknowledge that I have read, understand and commit to abide by these rules.