Modern wooden house with wavy roofline, surrounded by tall grass and trees, mountains in the background.
Scenic view of a mountain range with partly cloudy sky and a lake in the foreground.
Snow-capped mountain range under cloudy sky with a small modern building and green hill in foreground.
A modern house with a wooden exterior overlooking a lake or river, with mountains in the background, trees, and a grassy area in the foreground during what appears to be sunrise or sunset.

Therapy Agreement & Terms of Service

Bruchy Moskovics, CSW, CCLS

CONFIDENTIALITY:

What you share stays between us, with these exceptions:

  • If you are in danger of harming yourself or someone else

  • If a child, elder, or dependent adult is at risk

  • If required by a court order

  • If you give written permission to share with someone else

Your records are private and stored securely. I follow HIPAA guidelines.

Welcome.

Please review the sections below, and enter your signature to indicate you have read, understand, and agree to these terms of service.

CANCELLATION AND BOOKING:

Sessions are by appointment. As you begin your consistent therapy, you may receive a weekly time that is yours on the calendar on a regular basis.

I request 24 hours’ notice to cancel or reschedule.


Missed sessions without notice and late cancellations are billed at the full rate.

FEES AND PAYMENT:

My current individual session fee is $300/50 minutes.

My current couples session fee is $550/90 minutes.

Payment is due at the time of service. I accept Zelle, and credit card payments upon request.

I do not bill insurance.

TELEHEALTH:

Sessions take place using the internet and online, secure meeting platforms such as Zoom and Teams.

Please have a quiet, private space and stable internet. If our call drops, I will call or message you to reconnect.

DOCUMENTS & RECORDS:

I keep brief notes from our sessions in a secure, private system.

You’re always welcome to ask questions or request a summary of your work.

NATURE OF SERVICES:

I provide educational, consultative, and counseling services designed to support personal growth and the evolution of systems.

QUALIFICATIONS AND TRAINING:

NYU Silver School of Social Work: Master’s of Social Work

Brigham Young University: Master’s Equivalent, Child Life Specialist

PACT Institute: The Psychobiological Approach to Couples Therapy

After holding a license for several years in the State of New York, I now practice in different locations across the world, both in and out of the United States of America. Thus, all services are provided on a consultation basis and are not psychotherapy or mental health treatment provided under a state professional license.

BOUNDARIES AND RELATIONSHIP:

Therapy is a sacred, professional relationship. I will not engage in friendships, dual roles, or outside exchanges with clients. Text and WhatsApp chats are reserved for scheduling and logistics, and all content is to be brought into session directly. Between sessions, I may not respond immediately to emails or texts. In emergencies, please contact 911 or a local crisis line.

NOTE FROM THE THERAPIST:

It is an honor to embark on this journey with you. I take your investment seriously, including the time, money, energy, and commitment that it takes to make therapy work.

Every single person can achieve what they wish for in life, including you. I look forward to the unfolding of your story and to witness you reconnect with the deepest truth of who you really are.