Please fill out and read the entire page.  You are under no obligation until an initial free intake meeting is set to discuss your personal coaching goals.  All information given is confidential and delivered directly to Aaron.

Expectations from Recovery Coaching: Client’s Responsibilities 
People approach professional intervention for substance abuse and other 
compulsive behaviors for a variety of reasons. Most of the time it is 
when the pain point and crisis levels have become unmanageable and, 
frankly greater than the fear of getting help. 
Often there is pressure from family members, spouses, partners, friends, 
colleagues, etc. for us to seek the help we need when we have exhausted 
most other options. It may be determined that treatment (either 
inpatient, residential, partial hospitalization programs - PHP, or intensive 

outpatient programs – IOP) are recommended. In those instances we 
have a wide variety of treatment centers (both locally and around the 
country) at our disposal that accept a wide variety of insurance plans. In 
most cases we can arrange for a transition to a facility within 48 hours or 
less. This is not always a necessary measure. 
Much of the work that is necessary for recovery can be done by regular 
visits and exploring the “why” behind the “what” when it comes to our 
drinking/using. We will explore a combination of cognitive 
restructuring, spiritual belief systems, potential physical impediments/ 
disorders (medical referrals when necessary), personal family dynamics, 
potential genetic predispositions, and behavioral habits that when 
examined in context tell us a great deal about what we might be 
“drinking/using at”. 
We may, at some point strongly encourage the eventual participation of 
family members, spouses, partners, and anyone who may be part of our 
day to day circle of close loved ones to engage in coaching in order to 
best understand the disorders of substance abuse and ideally reduce the 
likelihood of setting our loved one up for relapses. Addiction is a 
family disorder. 
As a client, you will be expected to take an active role. As a 
professional, I can assist in effecting change, but cannot guarantee a 
specific outcome. You will determine the direction and be ultimately 
responsible for growth. If at any time you are dissatisfied with our work 
together, please let me know in order that we can move together toward 
a solution. It is also important to note that recovery can be a 
relapsing/remitting process. In other words, it will take time and a 
long-term commitment to begin to realize our goals of long-term 
sobriety. Staying the course and pushing through the discouraging times 
will yield a wealth of rewards that are waiting on the other side. 
Desperation and frustration are all part of the process. We will push 
through together and create a safe environment to explore everything 

that needs to be said, confessed, and owned in order to achieve a sober 
and healthy lifetime of joy and serenity!

Confidentiality
All information you reveal will be treated with strict confidentiality 
according to the attached HIPPA regulations. This means that the 
information will not be shared with anyone with the following three 
exceptions (1) when you have given written consent to share the 
information with a specific person or agency, (2) when it is deemed that 
you are at risk of hurting yourself or another person and (3) Tennessee 
law requires that child abuse in any form be reported to the Department 
of Human Services. 

If you have been referred by a physician or other health care or mental health care professional, it is professional courtesy to maintain contact, 
as necessary, with that referral source. This may be done unless you request otherwise. Confidentiality waivers will be provided for signatures in the case that we would need to communicate with other professionals regarding care. 

Parents or legal guardians will have access to pertinent information related to their minor children (under 16 years of age). Unless the courts have terminated parental rights, both parents have equal access to the records and information regarding minor children. 

Referral
It is sometimes necessary to make a referral to another mental health professional to better accommodate your needs. If this is the case, every effort will be made to help you find an appropriate, affordable source of help. It may also be beneficial to make a referral to another source of help, such as a psychiatrist, lawyer, or self-help group. Your written permission would be obtained before any information could be released

Cancellations
Twenty-four hour cancellation is required in order to avoid paying the fee for a missed session. Voice mail is available 24 hours a day to receive your call.

 

 OUR SERVICE AGREEMENT 

  • Appointments must be canceled at least 24 hours prior to the appointment or the client will be billed for that session. 
  • Out-of-office consultations---hospital visits, home visits, treatment facilities, court appearances, or other types of consultations (which require the therapist to leave the office to provide counsel or consultation), can be provided to the client at a fee of $125 per session hour. Travel time to and from will be billed at this same rate. 
  • Expenses incurred in coaching are the responsibility of the person receiving the service (or your legal guardian). 
  • Consultation with referral sources on the client’s behalf will be billed at the existing rate for the portion of the time utilized to provide the consultation. 
  • Therapy sessions are billed out at a 60-minute “clinical hour”. Sessions are $100 per clinical hour. Insurance is not accepted but invoices are available upon request in the event that you may want to submit something to your personal insurance provider or HSA. 
  • Payment is due when services are received. Major credit cards are accepted through square, or paypal (details discussed during initial meeting) .
  • If for any reason payment for services is not received within thirty (30) days after the services were rendered, there will be a $25 per month carrying charge. 

NOTICE OF PRIVACY PRACTICES 
This document describes how your mental health information (MHI) as a client of Aaron Porter may be used and disclosed: 
A: Commitment to Privacy 
I know how important your personal MHI is and am committed to respecting and protecting it. In conducting sessions, I will create notes regarding you and your treatment. I am required by law to maintain the confidentiality of all MHI that identifies you. I am also required by law to provide you with this notice of my legal duties and my privacy practices. 
B. Uses and Disclosures of Mental Health Information (MHI) Mental Health Care Operations: I may use and disclose your protected MHI for mental health care operations, which will include internal administration such as record keeping, billing, appointment setting and reminders, voicemail messages to you and mailings to your home address. 
Your Authorization: 
In addition to my use of your MHI for treatment, payment or operations, you may also give me written authorization to use your MHI or to disclose it to anyone for any purpose. If you give me an authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosures permitted by your authorization while it was in effect. Unless you give me a written authorization, I cannot use or disclose your MHI for any reason except those defined in this notice. 
Required by Law: I may use or disclose your MHI when I am required to do so by law. This would include reporting child abuse and/or neglect to the authorities authorized by law to receive such reports, and disclosure of your MHI to the extent necessary to avert a serious threat to your own safety and health and /or the safety and health of others. 
C. Use and Disclose Requiring Your Written Authorization 
I will not use or disclose your confidential information for any purpose other than the purposes described in the notice, without your written permission. For example, I would not supply confidential information to a research organization or to a prospective employer without your signed consent/request.