Greater Change Health LLC: Terms & Conditions
All paying customers who agree to the terms and conditions by checking the box during the checkout process are hereby legally bound to the following agreement with Greater Change Health.
By agreeing to these terms, you authorize Greater Change Health to charge your credit card through Stripe via SimplePractice or any designated billing platform for services rendered under the Greater Change Health Subscription Therapy Model. Charges will appear on your bank or credit card statement as Greater Change Health. You may request a paper copy of this agreement at any time. A “month” refers to a twenty eight (28) day billing cycle.
1. Overview of Services
Greater Change Health provides mental health services through a subscription-based teletherapy model designed to deliver affordable, accessible, and culturally competent care.By signing this Agreement, you consent to receive services under this model and agree to all policies, procedures, and financial terms outlined below.For clarity, a “month” refers to a twenty-eight (28) day billing cycle.
2. Informed Consent for Psychotherapy
Nature of Therapy
Therapy is a collaborative process that may involve discussing difficult experiences and emotions. Outcomes vary and are dependent on your level of engagement.
No guarantees are made regarding specific outcomes.
Risks & Benefits
You understand that therapy may involve discomfort, including feelings of anxiety, sadness, or frustration, but may also lead to improved coping, insight, and well-being.
Confidentiality
Your information will be kept confidential except in the following situations:
- Risk of harm to yourself or others
- Suspected abuse or neglect (child, elderly, dependent adult)
- Court order or subpoena
- Legal or court-mandated treatment
- Professional consultation (without identifying information)
If we encounter each other in public, your privacy will be protected and the therapist will not initiate contact.
Billing Disputes and Verification of Services
In the event of a dispute or chargeback related to services rendered, you acknowledge and agree that Greater Change Health may use available records to verify services provided. This may include, but is not limited to, appointment history, session dates and times, attendance records, and relevant clinical documentation.
Any information used for this purpose will be limited to what is reasonably necessary to respond to the dispute and will be handled in accordance with applicable privacy laws, including HIPAA. By engaging in services, you acknowledge that these records may be used to demonstrate utilization of services and subscription status in the event of a billing dispute.
3. Telehealth Consent
You agree to participate in therapy via telehealth and understand:
- You may withdraw consent at any time
- Telehealth may limit certain observational aspects of care
- All HIPAA protections apply
- You are responsible for having a private, secure environment
4. Notice of Privacy Practices (HIPAA)
You acknowledge receipt and understanding of the Notice of Privacy Practices, which outlines how your Protected Health Information (PHI) may be used and disclosed.
You understand your rights including:
- Accessing your records
- Requesting corrections
- Requesting restrictions on disclosures
5. Subscription & Payment Terms
Subscription Model
You agree to the following pricing structure:
Monthly Membership Fee:
$35.00 per billing cycle
(Includes platform access, scheduling, care coordination, messaging)
Does not include therapy sessions
Session Pricing
$27.50 for each of the first three (3) sessions per cycle
$45.00 for the fourth+ sessions
Fees
Missed Appointment: $75.99
Late Cancellation (<24 hours): $50.00
Service Start
Services begin on the date of your first scheduled session, regardless of attendance.
Discounted Services
If you receive discounted or free sessions and miss or late cancel, your pricing immediately reverts to standard rates.
6. Credit Card Authorization
By signing, you authorize Greater Change Health to charge your card via Stripe for:
- Subscription fees
- Session fees
- Missed/late cancellation fees
You agree to:
- Maintain valid payment information
- Not dispute valid charges
- Remain responsible for all balances
Payment Recovery
If payment fails, Greater Change may:
- Retry charges
- Split charges into smaller increments
- Continue attempts until balance is resolved
You will be notified of any payment issues.
7. Insurance Disclaimer
You are responsible for all charges regardless of insurance outcomes, including:
- Denied claims
- Delays
- Coverage limitations
The monthly subscription fee is not covered by insurance.
8. Appointments & Communication
(From Subscription Practice Policy )
- Sessions are typically 60 minutes
- Cancel at least 24 hours in advance
- Therapist responses occur within ~24 hours when possible
Communication Limits
- Email/text = administrative only
- Not for therapy or emergencies
- No social media connections with therapists
EmergenciesIf in crisis, call 911 or go to the nearest emergency room.
9. Termination of Services
Services may be terminated if:
- You miss 3 consecutive weeks
- Payment obligations are not met
- Therapy is not clinically appropriate
Referrals may be provided if needed.
10. Minors
If under 18, a parent/guardian may have access to certain information. Boundaries will be discussed.
11. Cancellation of Subscription
Cancellation must be done via stripe or telling your therapist in session (or via the messaging portal).
Access continues until the end of your current billing cycle.
12. Entire Agreement
This document represents the full agreement between you and Greater Change Health and replaces all prior separate forms.
13. Acknowledgment & Consent
By signing below, you acknowledge that:
- You have read and understand all sections of this Agreement
- You consent to psychotherapy and telehealth services
- You authorize payment and subscription billing
- You acknowledge receipt of the Notice of Privacy Practices
- You agree to all policies, fees, and terms