Please visit the 515 Therapy COVID-19 related pages above by simply clicking on them!

COVID-19 Updates and Information

515 Therapy and Consulting

INFORMED CONSENT FOR IN-PERSON SERVICES DURING COVID-19 PUBLIC HEALTH CRISIS

 

Agreement to Minimize Exposure to Covid-19

To obtain services in-person at 515 Therapy, you agree to take certain precautions which will help keep everyone safer from exposure and sickness. If you do not adhere to these safeguards, it may result in your starting or returning to a telehealth arrangement.

  • You will only keep your in-person appointment if you are symptom free.

  • If you have symptoms of the coronavirus (e.g., cough, shortness of breath, fever of 100.4°F, chills, muscle ache, headache, sore throat, loss of taste or smell), you agree to cancel the appointment or proceed using telehealth.  If you wish to cancel for this reason, you will not be charged the cancellation fee.

  • You will arrive on time for your scheduled appointment but will not arrive early.

  • You will wash your hands or use alcohol-based hand sanitizer when you enter the clinic.  

  • You will adhere to the safe distancing precautions we have set up in the waiting room and therapy offices. For example, you will not enter the waiting room if there are already four (4) individuals present and chairs may not be moved.  

  • Masks are optional; but you are encouraged to wear a mask that covers your nose and mouth in waiting room/public areas. Due to the limited availability of masks, please supply your own.

  • Every attempt will be made to keep a distance of 6 feet from yourself and others and there will be no physical contact (e.g. shaking hands).

  • If children are brought for an appointment, you will make sure that your child follows all sanitation and distancing protocols. Only one adult present for a child’s session. Siblings/other children should not be present.

  • For adult sessions, only the client(s) should attend the appointment.

  • If your job exposes you to individuals who are positive for Covid-19, you will talk to your provider about the best method of treatment for you (telehealth, in-office appointments, using masks at your appointment, etc.)

  • If you or a resident of your home tests positive for the infection, you will immediately inform your clinician and will be provided treatment via telehealth for the time recommended.

  • No ill 515 Therapy employee will be allowed to return to work until 3 days after their symptoms have resolved and it has been at-least 10 days since their symptoms first appeared.

  • 515 Therapy is taking rigorous steps to reduce the risk of spreading the coronavirus within the office. Please let your provider know if you have questions about these efforts.

  • You acknowledge and understand there is an increased risk that COVID-19 can be transmitted in any place of public accommodation, including this independently owned and operated outpatient mental health private practice, who seeks to protect its employees and clients who come upon the premises. By entering the 515 Therapy and Consulting premises (in either Urbandale or West Des Moines) and / or receiving services, including but not limited to assessment, psychotherapy and medication management, you agree to assume these risks. You therefore consent to services rendered “in-office” on these terms and conditions.

  • If you decide at any time that you would feel safer staying with, or returning to telehealth services, your provider will respect that decision if it is feasible and clinically appropriate. Reimbursement for telehealth services is also determined by the insurance companies and applicable law. Please discuss with your provider and/or insurance company.

 

These precautions may change if additional local, state, or federal orders or guidelines are published.

West Des Moines

6600 Westown Pkwy., Suite 240

West Des Moines, Iowa 50266

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Urbandale

2327 70th St.

Rocklyn Office Park, Bldg. 4

Urbandale, Iowa 50322​

Please Note: Although every effort is made to protect confidentiality, it is not recommended that personal health information be delivered via un-encrypted e-mail or an online form, as it is not a secure form of communication. Please be aware that 515 Therapy & Consulting does not provide emergency services. In case of emergency, please call 911 or go to the nearest hospital.