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Positive treatment experiences depend on a good match. While it’s not entirely possible to judge this before meeting for the first time, the following are conditions for which Dr Anson WOULD be a possible match. Please review and sign the following statement if you would like to confirm appointment. Otherwise, please note you have 24 hours from the time appointment was made to cancel without repercussions.

I AM SCHEDULING THIS APPOINTMENT FOR MYSELF – I understand that treatment is most productive when we choose to do this work for ourselves. I understand Dr Anson works with individuals 18-65 who are able to schedule and make decisions about their own treatment.

I AM ABLE TO SECURE A PRIVATE PLACE TO HAVE APPOINTMENTS – I understand that privacy and confidentiality go both ways, and I am able to secure a private space for appointments without spouses, co-workers, roommates or passing strangers compromising our privacy. I understand that I cannot have a telehealth appointment while driving a car. Additionally, I understand that as an adult psychiatrist and psychotherapist, Dr Anson always sees and evaluates patients 1:1 without involving family or spouses, except to the degree required during emergencies.

I AM NOT CURRENTLY A RISK OF HARM TO MYSELF OR OTHERS – I understand that while treatment is a place to explore a number of thoughts and feelings, scheduling a telehealth appointment with Dr Anson is NOT an emergency evaluation, and that in case of acute suicidal or homicidal thoughts, I would need to seek emergency psychiatric evaluation from the nearest hospital.

I AM NOT SEEKING CONTROLLED SUBSTANCE PRESCRIPTIONS – I understand licensure, DEA regulations, and post-pandemic laws prohibit the prescribing of controlled substances via telehealth evaluation.

I HAVE NOT HAD FULL OR PARTIAL-HOSPITALIZATION IN THE LAST 6 MONTHS – I understand Dr Anson does intensive therapeutic work, but that this is NOT an intensive outpatient program (IOP). Additionally, I understand that if hospitalized in the last year I would need to submit documentation of stabilization at an IOP.

I HAVE NOT HAD RELAPSE OF EATING DISORDER SYMPTOMS IN THE LAST 6 MONTHS – I understand that telehealth is not appropriate for active eating disorder evaluations, which may require in-person examination and on-going medical monitoring.

I AM NOT EXPERIENCING HALLUCINATIONS OR OTHER PSYCHOTIC SYMPTOMS – I understand that telehealth is not ideal for the evaluation of perceptual disturbances. Furthermore, I understand that treatment of psychotic disorders may require a higher level of care than Dr Anson provides.

I AM NOT LOOKING TO DETOX OR HAVE ALREADY COMPLETED A DETOX – I understand that while Dr Anson offers consultation on a number of substance issues, telehealth is not appropriate for monitoring of acute withdrawal symptoms and that Dr Anson does not facilitate outpatient detoxification.

I AM NOT SEEKING DOCUMENTATION FOR SPECIFIC EVALUATIONS – I understand that Dr Anson does not do evaluations for the following: court cases; disability evaluations; emotional support animal documentation; neuropsychological testing or evaluations for ADHD, autism, learning disorders or academic accommodations; or mental competency evaluations. I understand that I may need to seek other specialists for those kinds of specific evaluations.

I AGREE TO PAY THE FEE PRIOR TO INITIAL APPOINTMENT – I agree to pay for the time and expertise Dr Anson commits to evaluations, regardless of outcome, and I understand that a link to pay will be emailed prior to the start of the appointment.


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