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PATIENT INFORMATION

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New patients:  Please complete the new patient documents prior to your office visit, so our time can be focused on our discussion.  Online patients, please complete the paper provided by AmWell.  Thank you.

ABOUT YOUR VISIT
Preparation for your appointment

 

Confidentiality
All information disclosed within sessions and the written records pertaining to those sessions
are confidential and may not be revealed to anyone without your written permission, except
where disclosure is required by law.

 

Delphini Solutions Psychology is dedicated to maintaining strict confidentiality of all
communications between you, your therapist, and any referring professional involved in your
treatment. As a client, you control whether or not and to whom confidential information will be
disclosed. There are expectations to confidentiality mandated by Florida Law. Under the following
circumstances, confidentiality will be breached:
1. Where there is reason to suspect a child, adolescent, or elder has been or will be
abused.
2. Where there is reasonable cause to believe that you pose a risk of imminent harm to
yourself or to someone else.
3. Where there is a valid court order compelling records or witness testimony.


Payments & Insurance Reimbursement
I accept checks and most major credit cards.  Because of the unique needs and circumstances of

my clients, I do work on a sliding scale. This is discussed on an individual basis only.

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My counseling services are self-pay only.  However, my receipt can be submitted to your insurance

company for reimbursement if you have out-of-network benefits.

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Invoices 

Clients requesting to make payment by invoice are requested to complete a payment authorization form.

The payment information provided will be used at the client’s request or when there is non-payment

for an appointment.

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Cancellation
Since scheduling of an appointment involves the reservation of time specifically for you, a
minimum of 24 hours notice is required for rescheduling or canceling an appointment. Unless we
reached a different agreement, half the appointment fee will be charged for sessions missed without

such notification.

 

Telephone Emergency Procedures
If you need to contact me between sessions, please call 321-947-8170
and leave a message and I will return your call as soon as possible.

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If an emergency situation arises, please indicate it clearly on the message including a

telephone number. If you are experiencing an emergency, please call 911.

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Safety Information

If you are in a crisis or if you or any other person may be in danger - don't use this site.

Call now 1-800-273-TALK (24 hours hotline) or 911.

 

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Thank you for contacting us.

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Delphini Solutions Psychology
Elaine D. Kring, Ph.D., LMHC, NCC

Office Counseling

Online Counseling

Support Groups & Workshops

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