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12343 Hymeadow Drive, Suite 2 F

Austin TX 78750
(512) 779-3539
www.lifelinefamilyenrichment.com
[email protected]

March 20, 2020


Greetings:
As your therapist it is my duty to provide you with quality, professional, supportive services in a risk-free
and safe environment. The last few weeks our city, state, nation and world have faced the COVID-19
crisis. COVID-19 has threatened the health, safety and well-being of the world. We all must do our part to
minimize the spread of this virus. Governmental officials have implemented rules of 10 and safe
distancing measures to both contain and minimize the spread as much as possible. This has included
school, businesses, city and state office closures resulting in increased fear and anxiety amongst citizens
everywhere. These increased stressors will mean many will need their behavioral health services more
than ever. However, in an effort to remain obedient to official’s request to stay home and provide my
clients with the quality counseling services they need, I have taken the necessary steps to provide
Telebehavioral Health (TBH) therapy (therapy via web) through Doxy.me. This option is for my clients
who do not want to take the risk of coming into the office. Because of my age and the fact that I have
Asthma, these demographics place me at-risk which means I should and avoid possible contact with
someone who might have the virus.
Should you choose to participate in counseling by way of TBH, you would simply go to my waiting room
through this link, https://doxy.me/lfecounseling at your scheduled appointment time provided. To
participate you will need to read, sign, scan and return the attached Client Telebehavioral Health
Informed Consent Form. If you are not comfortable with the online sessions, you may also consider
telephone sessions. Please be aware you are also allowed to continue face-to-face sessions in the office.
However, if you choose this option of care, all face-to-face sessions in the office will be cancelled for the
next two weeks or longer based on directions from government officials.
Tough times call for tough decisions. The safety of my clients as well as myself, is of the utmost
importance concern for me. Please know I am dedicated to maintaining your continuity of care and
support during this difficult time. Please follow the current official mandate to isolate yourself from
potential exposure to the best of your ability by remaining at home. Should you find yourself becoming
anxious limit your intake of news either by television or other social media streams.

Barbara Fountain, MAHS, LPC-Supervisor


Listed below are preferences offered for your counseling services. Please select the
service medium you prefer. Sign the form and return to my office via email. Should
you select telebehavioral health therapy remember you must also sign and return
the Client Telebehavioral Health Informed Consent form.

Client Therapy Selection

I am choosing to have my counseling sessions:

□Face-to-Face Therapy/Counseling
□Telephone
□Telebehavioral Health Therapy

_____________________________________________________________________________

Client Printed Name

X______________________________________________ _____________________________

Signature of Client or Legal Guardian

___________________,2020______________________________________________________

Date

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