Terms and Conditions

Last updated: August 17, 2025

1) Who We Are

We provide trauma-informed pelvic health occupational therapy (OT) in the home. Services are delivered only by clinicians licensed in the state where the client is physically located at the time of service (NY, NJ, or PA).

2) Scope of Care

  • OT focuses on function, participation, and quality of life. Interventions may include education, breathwork, movement and habit training, pelvic floor coordination, and—only with explicit consent—gentle external or internal techniques.

  • We do not provide emergency care. If you are experiencing a medical emergency, call 911 or go to the nearest emergency department.

3) Eligibility & Consent

  • You must be 18+ (or have a parent/guardian present and consenting for minors).

  • You’ll review and sign: Informed Consent, Financial Agreement, and HIPAA/Notice of Privacy Practices.

  • Chaperone option: You may request a chaperone for any visit, especially for sensitive examinations or procedures. We will honor or help arrange that request (recommended best practice in NJ for intimate exams).

4) Referral Requirement

  • All patients must have a current referral/order from a licensed physician or qualified healthcare provider (e.g., physician, nurse practitioner, or physician assistant) before beginning occupational therapy services.

  • This ensures compliance with regulations across New York, New Jersey, and Pennsylvania and supports safe, coordinated care.

  • We will help facilitate obtaining or renewing referrals when needed.

5) Fees, Billing & Good Faith Estimates

  • Private pay only. We do not bill insurance.

  • Rates: Initial Evaluation $149; Follow-Up Treatment $99.

  • Superbills: Upon request, we’ll provide an itemized receipt (superbill) you may submit to your insurer. Reimbursement is not guaranteed.

  • Good Faith Estimate (GFE): If you are uninsured or self-pay, you are entitled to a Good Faith Estimate of expected charges for scheduled services, per the federal No Surprises Act.

6) Community Clinics

We periodically offer community-based clinics at discounted rates to improve access. Availability, locations, and eligibility vary; details will be posted or provided upon request.

7) Scheduling, Cancellations & No-Shows

  • Please provide 24 hours’ notice to cancel or reschedule.

  • Late cancellations/no-shows may be charged up to the full session fee.

  • We reserve the right to reschedule due to safety, severe weather, or clinician illness.

8) In-Home Safety & Environment

  • Ensure a smoke-free, safe area for care and notify us of pets, stairs, or hazards in advance.

  • A responsible adult must be present for minors.

  • We may discontinue or reschedule if the environment is unsafe.

9) Privacy & Communications

  • We safeguard your health information in accordance with HIPAA. You’ll receive our Notice of Privacy Practices, which explains how we use/disclose your information and your rights (access, restrictions, amendments, complaints).

  • Electronic communications (email/text) have security safeguards; however, no system is 100% risk-free. You may opt out of non-essential electronic messaging.

10) Records & Coordination

  • Upon request, we will share relevant records with your referring provider or other members of your care team to ensure continuity of care.

11) Professional Standards & Complaints

  • Our clinicians follow the laws and professional standards of each state’s OT board:

    • NY: Education Law Article 156 & applicable guidance.

    • NJ: OT Advisory Council regulations (N.J.A.C. 13:44K).

    • PA: State Board of OT Education & Licensure; 49 Pa. Code Chapter 42.

  • You may file concerns with the relevant state board; contact details available on state websites.

12) Payment

  • Payment is due at the time of service (cashless preferred). Returned or disputed payments may incur a processing fee.

13) Internal/Intimate Techniques

  • Any internal pelvic assessment/treatment is always optional and requires separate informed consent at each visit. You may request a chaperone, stop at any time, or switch to external-only care without penalty.

14) Limitations

  • We do not guarantee outcomes. Your participation (home practice, follow-ups, medical coordination) is part of the process.

  • We do not prescribe medications or provide medical diagnoses beyond OT scope.

15) Changes to These Terms

We may update these Terms to reflect changes in law or practice. The “Last updated” date will change when revisions occur.