My Policies
Confidentiality: All services are provided in a safe, non-judgmental, confidential and supportive environment to assist clients to work towards transformation, personal growth and wellbeing. Information is not released to third parties without prior client permission. Exceptions to confidentiality are determined by law.
Cancellations: I hold your appointment just for you. “No Show” or non-emergency cancellations with less than 48 hours notice will result in being charged the full session fee unless I can schedule someone for your time slot.
Phone Calls: There is no charge for brief phone calls for clarification of after-session instructions, to change an appointment, or for agreed upon session follow-up. Extended conversations will be charged at a pro-rated fee based on my hourly fee. It is always best to discuss your concerns during the session time.
Emails and Texts: I only use emails and texts for the purpose of setting up and changing appointment times. I do not conduct therapy via email and text. Texts are ONLY received on 617-686-4358; do not text me at 510-649-9624. If you do not receive a prompt response to your email or text (within 48 hours), please call and leave a message.
Payment: You are responsible for payment of all treatment charges. Payment is due at the time of each visit unless otherwise arranged. I accept cash, personal checks, and credit cards. Payment for packages is non-refundable and non-transferable, so please be certain that you want to use all sessions prior to purchasing a package.
Your insurance company may partially reimburse you for in-person psychotherapy services – I am happy to provide you with a receipt to seek reimbursement. Insurance companies do not reimburse for Shamanic Healing services, phone or internet based services. I do not bill insurance companies directly for psychotherapy services.
You can download a copy of these Policies Here: Policies
Notice of Privacy Practices: Privacy Practices-handout– Dr. C. Girvani Leerer
Complementary Nature of Shamanic Services
Shamanic Energy Healing Services are offered to complement medical and psychological advice and treatment. All services are alternative and complementary to healing arts services licensed by the State of California, and are not intended to be a substitute for medical or psychological care.
Shamanic Energy Healing services are ancient methods that address the energetic and spiritual aspects of life conditions and are not licensed by the state of California. Although Girvani Leerer is licensed as a Psychologist in California (License #24631) and Massachusetts (License #7289), she is not functioning under these licensures when providing Shamanic Energy Healing Services, and she does not diagnose, treat or prescribe for any physical or mental conditions.
This disclosure is intended to fulfill the requirements of the California Senate Bill #SB577, passed in September 2002.
Forms for New Clients
Please print and bring or mail these forms for your first appointment
- New Client Agreement and Disclosure Client Agreement and Disclosure
- New Hypnosis Client Agreement Hypnosis Client Agreement
- New Client Information Form New Client Information
- (For Psychotherapy) Receipt of Privacy Practices Receipt of Privacy Practices
Other Forms for Clients
- Release of Information Form Authorization to Release Information