Allan C. P. Belem - Psychologist
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Terms and Conditions
Fees and Payment​
Payments can be made by Credit Card via the It’s Complicated platform (with a 4% processing fee)
or by Bank Transfer (without an added processing fee).
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Public health insurance is not accepted at this time.
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Clients with private health insurance should check with their provider for potential coverage.​
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The Client will receive an invoice via email following their scheduled session and is required to
complete payment within 24 hours before receiving services.
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If payment is not received within this timeframe, the Therapist will issue a written reminder, and the Client will have one week to respond and issue payment. Outstanding invoices not paid within
this timeframe may be subject to late payment fees and, if necessary, legal action.
Cancellation and Rescheduling
If you need to cancel your appointment, please notify the Therapist via email or phone at least 24
hours before the scheduled appointment. The session will be charged in full if these conditions
are not met. If you reschedule your appointment within the same week, the cancellation fee will
not apply.
Use of Technology
The Therapist utilizes billing software (e.g., Sorted and It’s Complicated) to issue invoices.
Client identifying information (name, address, phone number, etc.) is stored securely within this
softwares.
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For secure messaging, end-to-end encrypted video call sessions, and booking purposes, the
Therapist uses Google Meet. If the Client prefers a different conferencing platform (e.g., Zoom,
Skype, Facetime, Signal, etc.), they must inform the Therapist in advance. By accepting online
therapy, the Client acknowledges the potential security risks associated with the chosen medium
and is responsible for maintaining their privacy during online sessions.
Confidentiality and Privacy
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All psychological counseling sessions are confidential. Client records are securely stored in a
locked filing cabinet. Any electronic data (e.g., emails, chat sessions) is kept on a password-
protected computer accessible only by the Therapist. Client files and therapeutic documents may
also be stored on international cloud services, which are secured with multifaceted password
protections accessible only by the Therapist.
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These files remain the property of the Therapist for seven years. After this period, they will be
securely disposed of to protect client privacy. Should it be necessary to discuss your case with
another professional, family member, or any other person, you will be required to complete a
‘Client Release of Information Form’.
Exceptions to Confidentiality
There are three exceptions in which a breach of confidentiality may occur without your consent:
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1. The Therapist's duty to report suspicion of abuse or neglect of children or vulnerable adults.
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2. The Therapist's duty to protect and warn in cases of potential suicide, potential homicide,
or an explicit threat of imminent serious physical harm to another individual.
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3. The Therapist will disclose only the minimum necessary information to the emergency
contact to address an immediate safety concern.
4. A notarized subpoena from a court requiring the release of information.
Termination
The Client may terminate the therapeutic relationship at any time if they feel their therapy is not
progressing as desired. Likewise, the Therapist reserves the right to terminate therapy if it is
deemed necessary.