Post on 22-Oct-2021
Register online
Trial session 15-20 min
Send proof of payment
1ST SESSION: Initial evaluation
Treatment
AFTER 4 WEEKS: receive IE report
5TH WEEK: report discussion
Treatment
AFTER 6 MONTHS: Progress report
AFTER 1 YEAR: re-evaluation
Version August 2020
E-THERAPY Policies and Guidelines
Policy and Guidelines Haven E-Therapy P a g e | 2 version August 2020
I. E-Therapy
TELEHEALTH is defined as “the use of information and communication
technologies (ICT) to deliver health‐ related services when the provider and client are in different physical locations.” (World Federation of Occupational Therapy, 2014). For the purpose of our program, we will use the term E-THERAPY for TELEHEALTH. E-THERAPY is an ideal practice model to ensure continuation of therapy services while guaranteeing safety amidst the COVID19 COMMUNITY QUARANTINE. TELEHEALTH has long been a practice model in other countries and is reported to be effective in addressing various developmental concerns for children in their home context. It is also effective in increasing parent engagement in the therapeutic process. A third-party application or software will be used which include Facebook Messenger, Skype, Zoom, Viber, and Google Hangouts. It will be utilized due to its accessibility and familiarity to all clients.
II. Attendance
□ I agree that attendance is important in building rapport and ensure
continuous progress of my child
□ I agree to sign-in on time. My session will be forfeited after 20 minutes of waiting time and I will be charged with a NO-SHOW FEE.
□ I agree that sessions can be rescheduled ONLY if I give a notice 3 hours before the session. Otherwise, my session will be forfeited.
III. Child Care and Safety
□ I agree that I will make sure that the working environment at home is safe, free from clutters, well-lit and well ventilated.
□ I agree that I will be the primary teacher at home and will participate with the session as instructed by the therapist
□ I agree that I have disclosed pertinent medical conditions like allergies, seizure, etc.
□ I agree that I have disclosed pertinent dietary restrictions.
□ I agree that Haven of Learning Tutorial and Therapy Center Co. may share my personal information with government agencies when there is evidence of abuse, neglect, or domestic violence.
Policy and Guidelines Haven E-Therapy P a g e | 3 version August 2020
□ I understand that Haven of Learning therapists will utilize Evidenced-Based Techniques which will not cause any direct harm to your child. However, for any untoward incidents during the E-THERAPY session, both the therapist and the parent will be liable. The therapist will exercise the necessary preparations to make sure that the therapy procedure will be safe. It is the parent’s responsibility to make sure that the working space is safe.
IV. Payment of Fees
Services Rates
Trial (15-20 minutes) FREE
Initial evaluation with formal report (OT, SP) P 1,800
Regular treatment session (OT, SP) P 700
Re-evaluation with formal report (OT, SP) P 1,800
Parent-teacher conference (OT, SP) P 1,800 +300 after 2 hours
Progress report (2-week notice) FREE
RUSH Progress report (less than 2 weeks) P 600
□ I agree that payment must be settled before the scheduled consultation. It
may be settled via bank transfer or G-cash payable to Marian A. Solitario, BDO savings account number 00127-1770-278. G-cash number is 09988414023. Parents will then send a picture or screenshot of the payment details on Facebook messenger: haven.etherapy or via email to havenoflearning@gmail.com
□ I understand that failure to pay the online therapy session will result in cancellation of the session.
□ I understand that a NO-SHOW FEE of P350 will be deducted from my deposited payment if I fail to sign in within 20 minutes of my scheduled session. If I am available, the therapist will only consume the remaining time. If I am not available the balance of P350 must be settled before the next session.
□ I understand that the therapist will not accommodate 5 days’ notice for progress reports.
V. Records and Confidentiality
□ I agree that video, audio and/or photo recordings may be taken during the
consultation process but only for progress monitoring. HAVEN OF LEARNING therapist will comply with the provisions of DATA PRIVACY LAW. NO VIDEO, AUDIO, OR PHOTO RECORDING WILL BE ALLOWED
Policy and Guidelines Haven E-Therapy P a g e | 4 version August 2020
TO BE UPLOADED IN ANY SOCIAL MEDIA PLATFORM without prior consent from the parents and Haven of Learning Staff.
□ I understand that therapy notes will be provided after or during the session and will be sent via electronic means.
□ I understand that evaluation report will be sent to me after 4 weeks. Additionally, I understand that the center REQUIRES 4 TREATMENT SESSIONS BEFORE INITIAL EVALUATION REPORTS WILL BE RELEASED. A summary report will be released instead if I don’t comply with this requirement.
□ I understand that I can request progress reports after 6 months of treatment session. Furthermore, I understand that progress reports will be sent to me ONLY after 2 weeks of notice.
□ I understand that if needed, my therapist may communicate with teachers at my child’s school/daycare regarding therapy evaluation results/sessions in order to help carry-over skills learned in therapy sessions
V. Internet and software conditions
□ I understand that a third-party application or software will be used which include Facebook Messenger, Skype, Zoom, Viber, and Google Hangouts.
□ I state that have registered accounts and agreed to the TERMS AND CONDITIONS of the third-party software.
□ I understand that due to the nature of online therapy services, parents/guardians agree to release HAVEN OF LEARNING and its employees for any breach of confidentiality that may occur with information transmitted over the internet. HAVEN OF LEARNING will not share information with 3rd parties or referral sources over the internet.
□ Strict strategies will be employed by our therapist to ensure that equipment and connections are secure and we will take steps to make certain unauthorized third parties will not accidentally enter the room during E-THERAPY session.
□ I understand that E-THERAPY sessions may also be disrupted due to technology or equipment failures. Therapy time will be offset to accommodate any delays in transmission. As needed, I may also negotiate with the therapist for possible re-scheduling to consume the remaining therapy time.
Policy and Guidelines Haven E-Therapy P a g e | 5 version August 2020
VII. Office Rules
□ I understand that E-THERAPY session will last for 1 hour. The therapist will
spend 45-50 minutes directly coaching the parent or supervising the child depending on the agreed upon goals. The parent will have the remaining 10-15 minutes to discuss the child’s session with the therapist and ask questions if necessary. The therapist will also document the day’s session at this time.
□ I agree that my therapist may communicate with me regarding therapy sessions (including progress, attendance, scheduling, etc.) via text, and email.
□ I understand that if a divorce or separation situation exists, a custody agreement and separation agreement will need to be shared with Haven of Learning Tutorial and Therapy Center Co. I will share custody agreements with my therapist/ Haven of Learning Tutorial and Therapy Center Co. so that my therapist only shares information with legal guardians of my child.
□ I understand that for any concerns or complaints about my therapist, Haven of Learning has designated Wea Ramirez, administrator of Haven of Learning, to serve as grievance officer to hear and handle disputes. Ms. Ramirez can be reached at 0927-887-7138.
VIII. Risks, Solutions and Benefits
Strict strategies will be employed by our therapist to ensure that equipment and connections are secure and we will take steps to make certain unauthorized third parties will not accidentally enter the room during E-THERAPY session. However, despite our best effort to protect your privacy, breaches may occur due to the nature of E-THERAPY utilizing Facebook messenger, Skype, Zoom, Viber, or Google Hangouts.
Our therapist will utilize Evidenced-Based Techniques which will not cause any direct harm to your child. However, for any untoward incidents during the E-THERAPY session, both the therapist and the parent will be liable. The therapist will exercise the necessary preparations to make sure that the therapy procedure will be safe. It is the parent’s responsibility to make sure that the working space is safe.
You have been advised of all the potential risks, consequences and benefits of E-THERAPY. The HAVEN OF LEARNING ensures that the benefits outweigh the risks. The therapist has discussed with you the information provided above. You had the opportunity to ask questions about the information presented on this form
Policy and Guidelines Haven E-Therapy P a g e | 6 version August 2020
and the E-THERAPY consultation. All your questions have been answered, and you understand the written information provided above.
I have read and agree to participate in E-THERAPY consultation.
Parent or caregiver’s Printed Name
Date
_______________________________ Signature
Policy and Guidelines Haven E-Therapy P a g e | 7 version August 2020
2. Sign Consent Form. If interested to proceed, Haven ofLearning will send you a copy of the Consent Form and othersupporting documents.
3. Send a picture of the Signed form.
• If you do not have a printer, write the following on a paper,sign it, and send a picture.
3. Send proof of payment via G-cash or online bank transfer.
• Amount: P700/ session
• Account name: Marian A. Solitario
• BDO savings account number: 00127-1770-278
• G-cash: 0998-8414-023
• Send screenshot to Facebook messenger: haven.etherapy
1. Trial Session. Schedule a preferred date and time withyour therapist. Trial session is a 15-20 minute interview.
5. Start of e-therapy (60 minutes) . It could either be a one-on-one direct supervision with your child or parent coaching. You willreceive therapy notes via electronic means.
6. Schedule another session. Send proof of payment and set
schedule with your therapist.
Appendix 1
Policy and Guidelines Haven E-Therapy P a g e | 8 version August 2020
REMINDERS
In preparation for the session, please do the following: Use a laptop or tablet with a webcam. If you will use a
smartphone, please set it on a phone stand, tripod, or some way
of propping it securely during the session.
Login a few minutes before the session to make sure that your
internet connection is good and the app (Skype, Messenger,
Zoom, Google or Hangouts) works on your device.
Place the device in a place where you and your child can be
easily visible to the therapist watching you and vice versa.
Depending on the set goals, expect to also move around.
The therapist will inform you beforehand to prepare the other
necessary materials.
Please make sure that the working environment is safe, with
adequate lighting, and comfortable ventilation. Ensure that no
unnecessary clutter is around the working space and all
electronic cables must be also secured.
If siblings need to be around, please inform the therapist so that
he/she can plan accordingly. Please ensure that your child
wears comfortable clothing
The therapist will need a dedicated person/adult present and
available during the session.
Please be reminded that NO VIDEO, AUDIO, OR PHOTO
RECORDING WILL BE ALLOWED DURING THE SESSION
without prior consent from both the therapist and the parent.
Thanks! See you!