Pathways | Forensic & Mental Health | Lufkin & Nacogdoches

I understand that I am responsible for my fee payment at or before the beginning of each appointment. I understand that agents of Pathways Forensic & Mental Health Services, PLLC (Pathways FMHS) will bill insurance directly when applicable, but I agree to be responsible for the full payment of fees for services rendered regardless of whether insurance reimbursement is obtained. I further agree that I am responsible for full payment of the billable amount should insurance reject or deny my claim. I hereby acknowledge I am requesting or have been Court Ordered to treatment through Pathways FMHS, but that I am not a client of any professional associated with Pathways FMHS until a treatment provider formally accepts me for treatment. Although the chances for obtaining my goals for therapy will best be met by adhering to therapeutic suggestions, I understand that I have a right to discontinue or refuse treatment at any time. I understand that if my treatment is Court Ordered, and I discontinue or refuse my treatment, my therapist is obligated to report my discontinuation of services to the Court. I understand that I am responsible for any balance due prior to a decision to stop therapy.