Disclosures
Client disclosures
Transparency is fundamental to the therapeutic relationship. The following information is provided in accordance with California law and professional ethics standards.
Practitioner Information
Name: Ann Tuszynski, LCSW
License Type: Licensed Clinical Social Worker (LCSW)
California License Number: Provided upon request
Education: Master of Social Work (MSW), University of Pennsylvania, 1972
Practice Address: Provided upon request
Phone: (707) 238-3782
Client Rights
As a client of Coastal Counseling, you have the right to:
- Receive competent, ethical treatment from a licensed professional
- Be informed about your therapist's qualifications, treatment approaches, and fees
- Ask questions about your treatment at any time
- Refuse any recommended treatment or end therapy at any time
- Receive a referral to another therapist if requested
- Be treated with dignity and respect regardless of race, ethnicity, gender identity, sexual orientation, religion, age, disability, or socioeconomic status
- Receive a copy of your treatment records upon request, as permitted by law
Confidentiality
All information shared during therapy sessions is strictly confidential and will not be disclosed without your written consent, except in the following circumstances required by California law:
- Danger to self or others: If there is a reasonable suspicion that you may harm yourself or another person, the therapist is required to take protective action, which may include notifying the potential victim, contacting emergency services, or initiating hospitalization.
- Abuse or neglect: Therapists are mandated reporters under California law. Suspected abuse or neglect of a child, elder, or dependent adult must be reported to the appropriate authorities.
- Court order: If a court of law issues a legitimate order requiring disclosure of information, the therapist may be required to comply.
Fees & Payment
- Fee schedules will be discussed and agreed upon before treatment begins
- Payment is due at the time of each session unless other arrangements have been made
- Cancellations must be made at least 24 hours in advance to avoid being charged for the session
- Sliding scale fees may be available — please inquire
Telehealth Disclosure
Coastal Counseling may offer telehealth (video/phone) sessions. By participating in telehealth services, you acknowledge:
- Telehealth involves the use of electronic communications to deliver clinical services at a distance
- There are potential risks including technology failures, interruptions, and limitations to confidentiality inherent in electronic communication
- You have the right to refuse telehealth services at any time and request in-person sessions
- All laws regarding client confidentiality and mandatory reporting apply equally to telehealth sessions
Filing a Complaint
If you have concerns about your treatment or believe your rights have been violated, you are encouraged to discuss them directly with your therapist. You also have the right to file a complaint with the licensing board:
California Board of Behavioral Sciences (BBS)
- Phone: (916) 574-7830
- Website: www.bbs.ca.gov
- Address: 1625 N. Market Blvd., Suite S-200, Sacramento, CA 95834
Informed Consent
By beginning therapy with Coastal Counseling, you acknowledge that you have read and understood these disclosures. A copy of this information will also be provided to you in writing at your first session, along with an informed consent form for your signature.