Terms and Conditions

I. Overview of Services

MayWeBlossom LLC provides outpatient mental health services delivered by Taija-Rae Guzman, a Licensed Clinical Social Worker (LCSW) licensed in the State of New York. Services may include individual psychotherapy, clinical assessment, diagnostic evaluation, treatment planning, group therapy, psychoeducation, and telehealth-based psychotherapy.

By scheduling, accessing, or receiving services, you acknowledge that you are entering into a professional clinical relationship governed by applicable New York State law, federal regulations, and professional ethical standards.

II. Clinical Informed Consent

Psychotherapy is a collaborative clinical process that involves discussing personal, emotional, behavioral, and psychological concerns. You understand that participation in therapy may involve emotional discomfort, including the discussion of distressing or sensitive material.

You acknowledge that psychotherapy is not an exact science, and that no guarantees can be made regarding outcomes, progress, or specific results. Therapeutic benefit is influenced by multiple factors, including your participation and engagement in the process.

You retain the right to ask questions regarding your treatment at any time and to be actively involved in decisions regarding your care.

III. Scope of Practice & Professional Role

Services are provided by a Licensed Clinical Social Worker (LCSW) practicing within the scope of licensure in the State of New York. Services are clinical in nature and are not a substitute for medical care, psychiatric services, legal counsel, or emergency services.

If at any point your needs fall outside the scope of outpatient psychotherapy, appropriate referrals or recommendations for higher levels of care will be provided.

IV. Fees, Insurance, and Financial Responsibility

All fees are disclosed prior to the commencement of services. By engaging in treatment, you accept full financial responsibility for all services rendered.

If insurance is utilized, you acknowledge that coverage is not guaranteed and remains subject to your individual policy terms. You are responsible for all copayments, deductibles, coinsurance, and any services not covered by your insurance provider.

You further acknowledge that billing insurance does not guarantee payment and that you are ultimately responsible for all charges incurred.

Fees are subject to change with reasonable notice.

V. Cancellation Policy

All appointment times are reserved exclusively for you. A minimum of twenty-four (24) hours’ notice is required for cancellation or rescheduling.

Failure to provide adequate notice or failure to attend a scheduled appointment will result in a 50% session fee being charged. Insurance providers typically do not reimburse for missed appointments, and such charges remain your responsibility.

Repeated missed appointments may result in a review of continued clinical services.

VI. Confidentiality and Privacy (HIPAA & NYS Law)

All information disclosed during treatment is protected under the Health Insurance Portability and Accountability Act (HIPAA) and applicable New York State confidentiality laws.

Your information will not be disclosed without your written consent except in legally mandated or permitted circumstances, including but not limited to:

  • Risk of serious harm to self or others

  • Suspected child abuse or neglect

  • Suspected abuse of a vulnerable adult

  • Court orders, subpoenas, or legal proceedings

  • Insurance billing, audits, or utilization review

  • Clinical consultation or supervision under confidentiality protections

You acknowledge that these legal exceptions may limit confidentiality in specific circumstances.

VII. Emergency Services Disclaimer

MayWeBlossom LLC does not provide emergency, crisis, or 24-hour on-call services.

If you are experiencing a psychiatric or medical emergency, you agree to contact:

  • 911 for immediate danger

  • The nearest emergency room

  • 988 Suicide & Crisis Lifeline (call or text 988)

Electronic communications (email, messaging, or portal systems) are not monitored continuously and must not be used for emergency situations.

VIII. Telehealth Consent

If telehealth services are provided, you consent to receiving psychotherapy through secure electronic communication platforms.

You understand that telehealth may involve risks including technological disruptions, limitations in confidentiality depending on your environment, and potential service interruptions.

You are responsible for ensuring that you participate in telehealth sessions in a private, secure setting. The provider reserves the right to determine clinical appropriateness of tele-health services at any time.

IX. Client Responsibilities

You agree to actively participate in your treatment process, provide accurate and complete clinical information, follow mutually agreed-upon treatment recommendations, communicate changes in your mental or physical health status, and maintain respectful communication with the provider.

X. Risks and Benefits of Therapy

You acknowledge that psychotherapy may involve emotional discomfort, including discussion of sensitive or distressing experiences. Potential benefits may include improved emotional regulation, insight, coping skills, interpersonal functioning, and psychological wellbeing. However, no guarantees are made regarding outcomes.

XI. Records and Documentation

Clinical records are maintained in accordance with New York State law and HIPAA regulations. You may request access to your records in writing, subject to applicable legal and clinical limitations. Records will not be released without your written authorization unless required by law.

XII. Termination of Services

Either you or the provider may terminate the therapeutic relationship at any time. The provider may terminate services for clinical, ethical, safety, or administrative reasons, including but not limited to nonpayment, repeated missed appointments, or lack of clinical appropriateness.

When appropriate, referrals to other providers or higher levels of care may be provided.

XIII. Intellectual Property

All materials provided by MayWeBlossom LLC, including worksheets, handouts, educational content, and digital resources, remain the intellectual property of MayWeBlossom LLC unless otherwise specified. These materials may not be copied, reproduced, or distributed without prior written consent.

XIV. Legal and Ethical Obligations

You acknowledge that clinicians are mandated reporters under New York State law and are legally required to report suspected abuse, neglect, or imminent risk of harm to appropriate authorities. The provider also adheres to all ethical standards governing Licensed Clinical Social Work practice in New York State.

XV. Agreement Acknowledgment

By scheduling, attending, or receiving services from MayWeBlossom LLC, you confirm that you have read, understood, and voluntarily agree to the terms of this Informed Consent and Service Agreement. You further acknowledge that you have had the opportunity to ask questions and receive clarification prior to beginning treatment.

MayWeBlossom LLC
Email: tguzman1@mayweblossom.com

Phone: 646-397-9077