Practice Policies
Every policy at Alafiora exists for a reason rooted in clinical integrity, mutual respect, and the enduring quality of our work together. Policies are not bureaucratic formalities here. They are the architecture of a container: the thoughtful, deliberate structure that makes depth-oriented work possible, sustainable, and safe for everyone it holds. Please read this page in full before your first appointment. Take notes if something warrants it. Bring questions to the consultation. You deserve to arrive at this work without uncertainty about what the container looks like, and I am committed to making certain that you do.
Attendance & scheduling
Cancellation, Rescheduling & No-Show Policy
When you schedule a session at Alafiora, that time is reserved for you and you alone. It is not double-booked, and it cannot be offered to another client. The hour you hold is a considered and protected allocation of clinical presence. I ask that you honor it with the same intentionality I bring to it, understanding that life is not always orderly and that this policy is designed to hold that reality with both firmness and grace.
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Notice Required - 48 hours in advance
No charge. If we reschedule within the same week, the fee is not collected until the rescheduled session is complete.
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Notice Required - Less than 48 hours notice
Full session fee is charged. The time was held and cannot be recovered.
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No notice given
Full session fee is charged without exception.
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Notice Required - Documented emergency
Please notify me as soon as you are able. Genuine emergencies, including hospitalization, accidents, and acute crises, are reviewed individually. We will discuss the possibility of waiving the charge together.
“Every client is extended one complimentary cancellation per quarter, with no charge and no explanation required. Quarters run January through March, April through June, July through September, and October through December. This grace is built into the structure intentionally, because I believe that life occasionally requires it and that a thoughtful practice acknowledges that.”
Attendance continuity
The four-in-four continuity policy
Consistent attendance is not a preference at Alafiora. It is a clinical requirement for the kind of work we do. Trauma-informed, depth-oriented care builds cumulatively. Gaps erode what has been carefully constructed. The following policy exists to protect both the integrity of your treatment and the sustainability of our therapeutic relationship.
If four or more sessions are cancelled, rescheduled, or missed within any four-month period, this constitutes a pattern that warrants a direct and honest clinical conversation
At the third cancellation within that window, we will meet to discuss what is happening, assess barriers, and consider adjustments to our structure, such as shifting to biweekly sessions, moving to week-by-week scheduling, or planning a brief intentional pause
If a fourth cancellation occurs within the same four-month window after that conversation, the therapeutic relationship will be thoughtfully and respectfully closed, with appropriate referrals provided
Clients who have been discharged under this policy are not eligible to return to Alafiora for a period of six months. Return after that period is possible and is evaluated through a new consultation with clear mutual expectations established in advance
“Five total cancellations or no-shows within a calendar year, regardless of quarter, will also result in discharge from the caseload with referrals provided. This is not punitive. It is a recognition that the level of care Alafiora offers requires a level of engagement that makes it possible. The container cannot hold what it is not permitted to hold.”
A note for Executive Concierge Retainer clients
The cancellation and no-show policy above does not apply to clients enrolled in the Executive Concierge Retainer. Retainer clients receive priority scheduling with flexible rescheduling and no late-cancel penalties, as long as appointments are rescheduled within the same calendar month and within mutually available hours. The terms of the retainer agreement govern all scheduling matters for enrolled clients.
Punctuality
Late Arrivals
Sessions begin at their scheduled time. If you arrive late, we will work with the time that remains and the session will conclude at its originally scheduled end. The full session fee applies regardless of arrival time. This is not a punitive policy. It is a structural one, designed to protect the clinical boundaries that make focused, effective work possible, for you and for every client whose time is held with equal care.
If you anticipate being late, please send a brief message through the secure client portal before the session begins. I will hold the space for fifteen minutes. If I have not heard from you and you have not arrived or connected by fifteen minutes past the scheduled start, the session will be considered a no-show and the full fee will apply.
Between sessions
Communication & Between-Session Contact
The boundaries around between-session contact are not designed to create distance. They are designed to protect the integrity of the therapeutic space and to ensure that the support you receive is genuinely clinical, not incidentally clinical. Alafiora is a specialized private practice, not a crisis line, and the quality of care I provide depends in part on the clarity of those boundaries.
Standard clients
Between-session communication is conducted through the secure client portal during standard business hours, Monday through Friday, 9am to 6pm
Messages are appropriate for scheduling, administrative matters, and brief logistical updates related to your care
Clinical questions, processing of session material, and requests for support between sessions are held for the session itself, or may be addressed through a scheduled Grounding Moment or Clarity Session
I respond to non-urgent messages within three business days as a matter of course
I do not provide clinical support, crisis intervention, or therapeutic processing via message, email, or phone outside of scheduled session time
Executive Concierge Retainer clients
Secure messaging access is included within the retainer during standard business hours, Monday through Friday, 9am to 6pm
Messages are reserved for scheduling, brief clinical check-ins, and treatment-adjacent logistics as defined in the retainer agreement
Responses to non-urgent messages are typically provided within three business days
Messaging is not monitored continuously and is not appropriate for emergencies or imminent risk
“This practice does not provide emergency or crisis services through any communication channel. If you are in crisis, experiencing a mental health emergency, or at risk of harm to yourself or others, please call 911, proceed to your nearest emergency room, or contact the 988 Suicide and Crisis Lifeline by calling or texting 988. A curated list of crisis resources is available on the Crisis Resources page of this website.”
Virtual care
Telehealth Requirements
Telehealth at Alafiora is not a lesser version of in-person care. It is a carefully structured, clinically equivalent modality that extends access to depth-oriented work across distance, and it carries its own requirements to be conducted with the same quality and safety as any in-office session. Please review the following before your first telehealth appointment.
Technical requirements
A stable internet connection sufficient for uninterrupted video
A device with a functioning camera and microphone, such as a laptop, tablet, or smartphone
Access to the secure, HIPAA-compliant telehealth platform used by Alafiora, confirmed prior to your first appointment
Headphones or earbuds are strongly encouraged for both privacy and audio quality
“If a technical disruption occurs mid-session, please attempt to reconnect through the platform. If reconnection is not possible within ten minutes, I will contact you through your preferred method on file to reschedule the remaining time. The session fee will be adjusted proportionally based on the time completed before the disruption, provided the disruption was not foreseeable or preventable on your end.”
Location requirements
You must be physically located in a state where I am licensed or authorized to practice at the time of each session. PSYPACT authorization currently extends telehealth across participating states. If your location changes, please notify me before the session begins.
Environment requirements
Sessions require a private, quiet space where you will not be overheard or interrupted. A car with the windows up, a locked room, or a private office are all appropriate. A shared space, a public location, or any setting where confidentiality cannot be reasonably maintained is not.
Your information
Records, Documentation & Releases
Your clinical record at Alafiora is maintained with the same discretion, precision, and care that governs every other aspect of this practice. It is stored securely, accessed only as clinically necessary, and never shared without your explicit, informed, and written consent, except where mandated by law. The following outlines how your records are maintained and how they may be accessed or shared.
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Maintained in your encrypted electronic health record. Not accessible to insurers, employers, or any third party without your written consent.
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Provided monthly upon request or automatically based on your stated preference. Contain only the information required for insurance submission or tax purposes.
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Released only upon your written authorization or as directed to the agreed recipient named in a signed Release of Information form.
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Drafted following a clinical conversation about the letter's purpose, audience, and content. Released to the named recipient upon your written authorization.
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Required before any information is shared with another provider, attorney, school, employer, or family member. Releases are specific in scope, time-limited, and revocable.
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In situations where law requires disclosure, including imminent risk of harm or child abuse reporting obligations, I am required to act. I will inform you of any mandatory disclosure to the extent that doing so is legally permissible.
“You have the right to request access to your clinical record, to request corrections where information is factually inaccurate, and to receive an accounting of disclosures made on your behalf. These rights are established under HIPAA and honored fully at Alafiora. Please submit record requests in writing through the secure client portal.”
Endings & transitions
Termination & Referral
Every therapeutic relationship at Alafiora is held with the intention that it will reach a natural and well-prepared conclusion: a moment when the work has fulfilled its purpose and you are genuinely ready to move forward without this particular container. That kind of ending is something we plan for together, with adequate time and attentive care. It is not something that happens abruptly or without your full participation.
There are, however, circumstances under which a therapeutic relationship may need to conclude before that natural endpoint is reached. In those moments, the same care and intentionality apply. You will never be left without a path forward.
Circumstances that may prompt a clinical discharge or transition
Attendance falling below the threshold of the four-in-four continuity policy, as described above
A presenting concern that evolves beyond the scope of my clinical specialization, where a different provider would serve you more precisely
A level of care need that requires a higher or more intensive level of service than outpatient private practice can safely provide
A boundary violation or safety concern that cannot be clinically resolved within the therapeutic relationship
Non-payment of fees after reasonable and documented attempts to address the matter
A determination, made jointly or independently, that the therapeutic relationship is no longer clinically productive or safe for either party
In all circumstances, termination is handled with dignity, transparency, and a genuine commitment to your continuity of care. Where referrals are appropriate, they will be thoughtfully provided. Where a planned transition is possible, it will be structured to honor the work we have done together and to prepare you for what comes next.
“If you wish to end the therapeutic relationship, you are free to do so at any time. I ask only that you communicate this decision directly, either in session or through the secure client portal, so that we can close the work with the same intentionality we brought to beginning it. A brief closing session is always available to clients who wish to mark the ending thoughtfully, and I encourage it.”
A final note
These policies are not the most important thing about Alafiora. The work is. But the policies are what make the work possible, sustainable, and worthy of the trust you bring to it. If anything here raises a question, bring it. If something feels unclear or unexpectedly activating, that is worth knowing too. The container is designed to be discussed, not merely endured. I look forward to beginning.