Terms of Service

1. ACCEPTANCE OF TERMS

These Terms of Service ("Terms") constitute a legally binding agreement between you ("Patient," "you," or "your") and Arizona Telepsychiatry Clinic ("Clinic," "we," "us," or "our"). By scheduling an appointment, accessing our services, or using our platform, you acknowledge that you have read, understood, and agree to be bound by these Terms and our Privacy Policy.

If you do not agree to these Terms, you must not use our services.

2. PRACTICE INFORMATION

3. ELIGIBILITY AND AGE RESTRICTIONS

3.1 Age Requirement

Our services are available ONLY to adults aged 18 years and older. By using our services, you represent and warrant that you are at least 18 years of age. We do not provide services to minors under any circumstances.

3.2 Geographic Limitation

Services are provided exclusively to patients physically located within the State of Arizona at the time of each telehealth appointment. You must be an Arizona resident or temporarily located in Arizona during your appointment. The provider is licensed only in Arizona and cannot provide services to patients located in other states or countries.

3.3 Patient Responsibilities

You represent and warrant that:

• You are 18 years of age or older
• You are physically located in Arizona during all telehealth appointments
• All information you provide is accurate, current, and complete
• You have the legal capacity to enter into this agreement
• You will notify us immediately if any of your information changes

4. SERVICES DESCRIPTION AND SCOPE

4.1 Services Offered

Arizona Telepsychiatry Clinic provides telehealth psychiatric services focused on:

• Comprehensive ADHD evaluations and assessments
• ADHD diagnosis using DSM-5-TR criteria
• Medication management for ADHD
• Follow-up care and treatment monitoring
• Medication adjustments and prescription refills
• Behavioral and lifestyle counseling related to ADHD management

4.2 Services NOT Provided

The Clinic does NOT provide the following services:

• Emergency psychiatric care or crisis intervention
• In-person office visits
• Treatment for active suicidal or homicidal ideation
• Intensive psychotherapy or counseling (we focus on medication management)
• Treatment for severe mental illness requiring hospitalization
• Substance abuse treatment programs
• Disability evaluations or letters
• Forensic evaluations
• Services to patients under age 18

4.3 Limitations

Telehealth has inherent limitations. While we strive to provide excellent care, telehealth may not be appropriate for all conditions or situations. The provider reserves the right to determine whether telehealth is appropriate for your specific needs and may refer you to in-person care if necessary.

5. PROVIDER-PATIENT RELATIONSHIP

5.1 Establishment of Relationship

A provider-patient relationship is established when you complete your first appointment with Lindsay Hart, PMHNP-BC, and the provider accepts you as a patient. This relationship is governed by professional standards, applicable laws, and these Terms.

5.2 Provider Discretion

The provider reserves the right to:

• Decline to establish a provider-patient relationship
• Terminate the relationship with appropriate notice (except in emergencies)
• Refuse to prescribe certain medications based on clinical judgment
• Refer you to another provider or specialist if appropriate
• Request additional medical records or information before treatment

5.3 Patient Responsibilities

As a patient, you agree to:

• Provide complete and accurate medical history
• Follow the treatment plan as prescribed
• Communicate openly and honestly with your provider
• Attend scheduled appointments or cancel appropriately
• Take medications only as prescribed
• Inform the provider of any side effects or concerns
• Notify the provider of any changes in your health status
• Comply with all applicable laws regarding controlled substances

5.4 Termination of Relationship

Either party may terminate the provider-patient relationship:

• By Patient: You may terminate at any time by providing written notice
• By Provider: The provider may terminate with 30 days' written notice, except in cases of:
  • Non-compliance with treatment plan
  • Abusive or threatening behavior
  • Non-payment for services
  • Suspected drug diversion or misuse
  • Providing false information
  • Repeated missed appointments

Upon termination, the provider will provide appropriate referrals and transfer of care information as clinically indicated.

6. APPOINTMENT SCHEDULING AND CANCELLATION

6.1 Scheduling

Appointments may be scheduled through our online booking system, by phone, or by email. You will receive confirmation of your appointment date and time. It is your responsibility to ensure you receive this confirmation.

6.2 Appointment Types and Duration

• Initial Evaluation: Approximately 60 minutes - comprehensive ADHD assessment
• Follow-up Visits: Approximately 20-30 minutes - medication management and monitoring

6.3 Cancellation and Rescheduling Policy

Required Notice: You must provide at least 24 hours' notice to cancel or reschedule an appointment.

• Timely Cancellation (24+ hours): No fee will be charged
• Late Cancellation (less than 24 hours): You may be charged the full appointment fee
• No-Show: Failure to attend a scheduled appointment without notice will result in a charge of the full appointment fee

6.4 Provider Cancellations

In the rare event that the provider must cancel or reschedule, we will make every effort to notify you as soon as possible and reschedule at your earliest convenience. No fees will be charged for provider-initiated cancellations.

6.5 Late Arrivals

If you are more than 15 minutes late to your appointment, it may be considered a no-show and you may need to reschedule. You will be responsible for any applicable fees.

6.6 Repeated Missed Appointments

A pattern of missed appointments or late cancellations may result in termination of the provider-patient relationship or requirement of prepayment for future appointments.

7. FEES AND PAYMENT TERMS

7.1 Service Fees

Current fees for services are as follows:

Fees are subject to change with 30 days' notice. Current patients will be notified of any fee changes.

7.2 Payment Methods

We accept the following payment methods:

• Credit cards (Visa, Mastercard, American Express, Discover)
• Debit cards
• HSA/FSA cards

7.3 Payment Timing

Payment is due at the time services are rendered. You authorize us to charge your payment method on file for:

• Scheduled appointment fees
• Late cancellation or no-show fees
• Any outstanding balances

7.4 Payment Plans

Payment plans may be available on a case-by-case basis. Please contact our office to discuss payment arrangements if you are experiencing financial hardship.

7.5 Outstanding Balances

Accounts with outstanding balances over 60 days may:

• Result in suspension of services until payment is received
• Be sent to a collection agency
• Incur additional collection fees and interest as permitted by law

7.6 Refund Policy

Refunds are provided only in the following circumstances:

• Duplicate billing errors
• Provider-cancelled appointments where you were incorrectly charged
• Technical failures that prevented the appointment from occurring

Refunds are not provided for services already rendered, dissatisfaction with clinical recommendations, or patient-initiated cancellations.

8. INSURANCE BILLING

8.1 Insurance Participation

Arizona Telepsychiatry Clinic may or may not participate with your insurance plan. Please contact our office to verify current insurance participation status.

8.2 In-Network Services

If we are in-network with your insurance plan:

• We will bill your insurance directly for covered services
• You are responsible for any copayments, coinsurance, and deductibles
• You must pay your portion at the time of service
• Your insurance determines what is covered; we will bill appropriately but cannot guarantee payment

8.3 Out-of-Network Services

If we are out-of-network with your insurance or you have out-of-network benefits:

• Payment is due in full at the time of service
• We can provide a "superbill" (detailed receipt) for you to submit to your insurance for potential reimbursement
• Any reimbursement is between you and your insurance company
• We make no guarantees regarding out-of-network reimbursement

8.4 Patient Responsibility

You are responsible for:

• Verifying your insurance coverage and benefits before your appointment
• Understanding your copayment, coinsurance, and deductible requirements
• Providing accurate insurance information
• Obtaining any required pre-authorizations
• Paying any amounts your insurance does not cover

8.5 Insurance Denials

If your insurance denies a claim, you are responsible for the full fee. We will work with you on payment arrangements if needed, but ultimately payment is your responsibility.

8.6 Medicare and Medicaid

Our current participation status with Medicare and Medicaid should be verified directly with our office. Participation may change over time.

9. TELEHEALTH CONSENT AND REQUIREMENTS

9.1 Informed Consent for Telehealth

By using our telehealth services, you consent to receiving healthcare services via secure video conferencing. You understand that telehealth involves the use of electronic communications to enable healthcare providers at different locations to share individual patient medical information for the purpose of providing clinical care.

9.2 Benefits of Telehealth

• Improved access to psychiatric care
• Convenience and reduced travel time
• Ability to receive care from home
• Continuity of care regardless of location (within Arizona)

9.3 Risks and Limitations of Telehealth

You understand that telehealth has potential risks, including but not limited to:

• Technical difficulties or interruptions may delay or disrupt care
• Security protocols could fail, causing a breach of privacy
• Lack of physical examination may affect diagnosis or treatment
• Technology may not adequately substitute for in-person care in all situations
• In rare cases, the provider may determine that telehealth is not appropriate and refer you for in-person care

9.4 Technical Requirements

To participate in telehealth appointments, you must have:

• A reliable internet connection (minimum 3 Mbps recommended)
• A device with camera and microphone (computer, tablet, or smartphone)
• Access to the telehealth platform we use (instructions will be provided)
• A private, quiet location for your appointment
• Adequate lighting so the provider can see you clearly

9.5 Patient Responsibilities During Telehealth Visits

You agree to:

• Be in a private location free from distractions
• Be physically located in Arizona for the duration of the appointment
• Have your camera turned on so the provider can see you
• Not record video or audio of the session without written consent
• Participate alone unless otherwise agreed upon with the provider
• Provide your current physical location and address at each visit
• Ensure adequate lighting and minimal background noise

9.6 Technical Difficulties

If technical difficulties interrupt a session:

• The provider will attempt to reconnect via the same platform
• If reconnection fails, the provider may contact you by phone
• If the session cannot be completed, we will reschedule at no additional charge
• Partial sessions may be billed at a reduced rate or rescheduled based on the circumstances

9.7 Privacy and Security

We use HIPAA-compliant, secure video conferencing platforms. However, you are responsible for ensuring the privacy of your location and the security of your personal devices.

9.8 Right to Refuse or Withdraw Consent

You have the right to refuse or withdraw consent for telehealth services at any time. This may result in termination of care if in-person alternatives are not feasible.

10. PRESCRIPTIONS AND CONTROLLED SUBSTANCES

10.1 Prescription Authority

Lindsay Hart, PMHNP-BC, is authorized to prescribe medications, including controlled substances, as part of ADHD treatment within her scope of practice and Arizona regulations.

10.2 Controlled Substance Agreement

ADHD medications often include controlled substances (Schedule II stimulants). By accepting treatment, you agree to:

• Use medications only as prescribed
• Not share medications with others
• Store medications securely
• Obtain controlled substances from only one provider
• Use only one pharmacy unless otherwise approved
• Submit to random drug screening if requested
• Report lost or stolen medications immediately
• Attend all scheduled follow-up appointments

10.3 Prescription Monitoring

We participate in the Arizona Prescription Drug Monitoring Program (PDMP). Your provider may check this database before prescribing controlled substances.

10.4 Refills

• Controlled substance refills require regular follow-up appointments (typically monthly or as determined by the provider)
• No early refills except in documented extraordinary circumstances
• Lost or stolen medications will not routinely be replaced
• Refill requests must be made during scheduled appointments or with adequate notice (at least 3 business days)

10.5 Pharmacy Requirements

You must designate a preferred pharmacy. Some controlled substance prescriptions may be sent electronically; others may require pickup or special handling per state regulations.

10.6 Violations

Violation of the controlled substance agreement may result in:

• Discontinuation of controlled substance prescriptions
• Termination of the provider-patient relationship
• Reporting to appropriate authorities if illegal activity is suspected

11. MEDICAL RECORDS AND PRIVACY

11.1 HIPAA Compliance

We comply with the Health Insurance Portability and Accountability Act (HIPAA) and Arizona privacy laws. Your health information is protected and will not be disclosed without your authorization except as permitted or required by law.

11.2 Use of Information

Your health information may be used for:

• Treatment purposes
• Payment and billing
• Healthcare operations
• Legal requirements (court orders, mandatory reporting)
• Public health and safety (as required by law)

11.3 Access to Records

You have the right to access your medical records. Requests must be made in writing. A reasonable fee may be charged for copying records.

11.4 Record Retention

Medical records are retained per Arizona law and professional standards (typically at least 6 years after the last date of service).

12. MEDICAL DISCLAIMER AND LIMITATION OF LIABILITY

12.1 No Guarantees

While we strive to provide high-quality care, we make no guarantees regarding:

• Specific treatment outcomes
• Diagnosis accuracy (psychiatric diagnoses involve clinical judgment)
• Medication effectiveness or side effects
• Complete symptom resolution

12.2 Standard of Care

Care is provided consistent with applicable professional standards and Arizona law. The provider exercises independent clinical judgment based on available information and accepted practices.

12.3 Limitation of Liability

TO THE MAXIMUM EXTENT PERMITTED BY ARIZONA LAW:

• Arizona Telepsychiatry Clinic and Lindsay Hart, PMHNP-BC, shall not be liable for any indirect, incidental, special, consequential, or punitive damages arising from your use of our services
• Our total liability for any claims related to our services shall not exceed the amount you paid for services in the six months preceding the claim
• We are not liable for technical failures, internet disruptions, or third-party platform issues beyond our control
• We are not responsible for any harm resulting from your failure to follow treatment recommendations

12.4 No Liability for Third Parties

We are not responsible for the actions or services of:

• Pharmacies that fill prescriptions
• Other healthcare providers you may see
• Emergency services
• Technology platform providers
• Insurance companies

12.5 Medication Risks

You acknowledge that all medications carry risks of side effects, adverse reactions, and interactions. You agree to:

• Read all medication information provided
• Report any concerning symptoms immediately
• Inform your provider of all other medications and supplements
• Understand that the provider is not liable for unforeseeable adverse reactions

12.6 Emergency Situations

We are not liable for adverse outcomes in emergency situations. You acknowledge that telehealth is not appropriate for emergencies and that you must seek emergency care when needed.

13. EMERGENCY SERVICES DISCLAIMER

13.1 Emergency Definition

An emergency includes but is not limited to:

• Thoughts of harming yourself or others
• Suicidal or homicidal ideation
• Severe medication reactions or overdose
• Acute psychosis or severe mental status changes
• Medical emergencies (chest pain, difficulty breathing, etc.)
• Any situation requiring immediate medical attention

13.2 Emergency Resources

In case of emergency, immediately contact:

• Call 911 for life-threatening emergencies
• 988 Suicide & Crisis Lifeline: Dial 988 (24/7 support)
• Crisis Text Line: Text "HELLO" to 741741
• National Suicide Prevention Lifeline: 1-800-273-8255
• Emergency Room: Go to your nearest hospital emergency department

13.3 After-Hours Care

Arizona Telepsychiatry Clinic does not provide after-hours or on-call services. If you experience a psychiatric emergency outside of business hours, use the emergency resources listed above.

13.4 No Emergency Response

You acknowledge and understand that:

• The provider cannot provide emergency services via telehealth
• Email and messages are not monitored 24/7 and should never be used for urgent needs
• Response to non-urgent messages may take 1-2 business days
• We cannot dispatch emergency services to your location

14. COMMUNICATIONS

14.1 Secure Messaging

We provide secure messaging through our patient portal for non-urgent communications. This may be used for:

• Refill requests (non-controlled substances)
• Non-urgent questions
• Administrative matters

14.2 Response Times

We will make reasonable efforts to respond to non-urgent messages within 1-2 business days. This is not appropriate for urgent or time-sensitive matters.

14.3 Email and Text

Regular email and text messages are not secure. Clinical information should not be sent via unencrypted email or text except for appointment reminders and general practice information.

14.4 Phone Calls

You may call our office during business hours for administrative matters. Clinical questions should be reserved for scheduled appointments or addressed through secure messaging.

15. PATIENT CONDUCT

15.1 Expected Behavior

We expect all patients to treat our staff and provider with respect. We maintain a zero-tolerance policy for:

• Verbal abuse, threats, or harassment
• Discrimination or hate speech
• Violent or aggressive behavior
• Sexual harassment or inappropriate conduct
• Intoxication during appointments

15.2 Consequences

Violation of conduct expectations may result in immediate termination of the provider-patient relationship and potential involvement of law enforcement if threats are made.

16. DISPUTE RESOLUTION

16.1 Informal Resolution

If you have concerns or complaints about our services, we encourage you to contact us directly so we can attempt to resolve the issue informally.

16.2 Mediation

If informal resolution is unsuccessful, both parties agree to attempt to resolve disputes through mediation before pursuing litigation. Mediation shall be conducted in Arizona with a mutually agreed-upon mediator. Each party shall bear their own costs of mediation, with mediator fees split equally.

16.3 Arbitration

If mediation is unsuccessful, any remaining disputes shall be resolved through binding arbitration in accordance with the rules of the American Arbitration Association. Arbitration shall take place in Maricopa County, Arizona, unless otherwise mutually agreed.

16.4 Exceptions

Notwithstanding the above, either party may seek injunctive relief in court for matters requiring immediate action, and collection actions for unpaid fees may proceed in small claims court.

16.5 Class Action Waiver

You agree that any dispute resolution shall be conducted on an individual basis and not as part of a class action, consolidated action, or representative action.

17. GOVERNING LAW AND JURISDICTION

17.1 Arizona Law

These Terms shall be governed by and construed in accordance with the laws of the State of Arizona, without regard to its conflict of law provisions.

17.2 Jurisdiction

To the extent that court action is necessary (and not subject to arbitration as described above), both parties consent to the exclusive jurisdiction of the state and federal courts located in Maricopa County, Arizona.

17.3 Regulatory Oversight

Lindsay Hart, PMHNP-BC, is licensed by the Arizona State Board of Nursing. Questions or complaints regarding licensure or professional conduct may be directed to:

18. MODIFICATIONS TO TERMS

18.1 Right to Modify

We reserve the right to modify these Terms at any time. Changes will be effective upon posting to our website or notification to patients.

18.2 Notice of Changes

Material changes to these Terms will be communicated to active patients via email or through our patient portal. Continued use of our services after changes indicates acceptance of the modified Terms.

18.3 Review Responsibility

It is your responsibility to review these Terms periodically. The current version will always be available on our website with the effective date clearly indicated.

19. SEVERABILITY

If any provision of these Terms is found to be unenforceable or invalid by a court of competent jurisdiction, that provision shall be limited or eliminated to the minimum extent necessary so that these Terms shall otherwise remain in full force and effect.

20. ENTIRE AGREEMENT

These Terms, together with our Privacy Policy and any other agreements you sign or consent to, constitute the entire agreement between you and Arizona Telepsychiatry Clinic regarding use of our services and supersede all prior agreements and understandings.

21. WAIVER

Our failure to enforce any right or provision of these Terms shall not constitute a waiver of such right or provision. Any waiver must be in writing and signed by an authorized representative.

22. ASSIGNMENT

You may not assign or transfer your rights or obligations under these Terms without our prior written consent. We may assign these Terms in connection with a merger, acquisition, or sale of assets with notice to patients.

23. ACKNOWLEDGMENT AND ACCEPTANCE

By scheduling an appointment or using our services, you acknowledge that you have read, understood, and agree to be bound by these Terms of Service. You further acknowledge that:

• You have had the opportunity to ask questions about these Terms
• You understand the limitations and risks of telehealth services
• You understand that telehealth is not appropriate for emergencies
• You are at least 18 years of age
• You will be physically located in Arizona during all appointments
• You consent to treatment via telehealth
• You accept responsibility for payment of services
• You agree to the dispute resolution procedures outlined herein

24. CONTACT INFORMATION

If you have questions about these Terms of Service, please contact: