A 48-hour notice is required for all cancellations, or the full session fee applies. For 2Ingage and BIPP clients, attendance is the primary investment in your success.

Policy on Attendance: After three consecutive no-shows, you may be discharged for non-compliance with treatment.

I am an out-of-network provider. I am currently contracted with some BCBS and Aetna policies. For all other providers, I can provide a monthly Superbill for you to submit for potential reimbursement.

Your health information is protected under federal and Texas law. Review my full Notice of Privacy Practices. Per the No Surprises Act, you have the right to a 'Good Faith Estimate' of costs before beginning treatment.

To request records, you must submit a written request using the Texas HB 300 Authorization Form. Email the completed form to stacy@brainandhearthealing.com. Requests are fulfilled within 15 days.

I do not perform custody evaluations or make legal recommendations regarding parental rights or conservatorship.

My testimony is limited to clinical observations and treatment progress within the scope of therapy.

Important Notice: Under the law, health care providers must provide patients who don’t have insurance or aren't using insurance with an estimate of the bill for medical items and services.

• Your Right to Information: You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

• Timely Delivery:

  • If you schedule a service at least 3 business days in advance, I will provide a Good Faith Estimate in writing within 1 business day of scheduling.

  • If you schedule at least 10 business days in advance, I will provide the estimate within 3 business days of scheduling.

• Requesting Estimates: You can also ask for a Good Faith Estimate before you schedule an item or service. I will provide it in writing within 3 business days of your request.

• Dispute Rights: If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the legal right to dispute the bill.

• Record Keeping: Make sure to save a copy or picture of your Good Faith Estimate.

• No Obligation: The Good Faith Estimate is not a contract and does not require you to obtain the items or services from Brain and Heart Healing.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.

SUD Record Protection:

• As part of your treatment, records regarding Substance Use Disorder (SUD) are protected under 42 CFR Part 2 (Updated Feb 2026).

Consent for Operations:

• By signing my intake forms, you provide a single consent for the use of your SUD records for Treatment, Payment, and Health Care Operations.

Legal Protections:

• Even with this consent, your SUD records cannot be used in criminal or civil proceedings against you without a specific, separate written authorization or a specialized court order.