Informed Consent

Updated April 2022

Services Offered at Tranquility:

At Tranquility, we realize how stressful it can be to try to establish care with a new provider, especially for mental health needs. As such, we aim to provide a patient-centered, nonjudgmental, compassionate environment where we hope you will feel comfortable discussing your concerns. While we offer many services to our patients, we think the greatest service you will receive is care with a personalized touch.

Following a thorough diagnostic evaluation, we will share our thoughts on your diagnosis, discuss potential evidence-based treatment options, and answer any questions you might have. We may recommend medication management, therapy, or a combination of both. Medication management typically works best in conjunction with therapy, so we will often recommend both treatment modalities.

Medication management follow-up appointments typically last 15-30 minutes and are scheduled at 2-12 week intervals, or as clinically appropriate. Our providers will always aim to use as little medication as possible to help alleviate your symptoms. While the focus of medication management appointments is typically assessment of your current symptoms, response to medication, and discussion of risks/benefits of medication options, our medication providers will also use psychotherapy in these sessions to propel you to wellness as quickly as possible. There are risks and benefits to medication management that will differ depending on medications, and these risks and benefits will be discussed in session. A parent or guardian of minor patients must be present for medication management appointments.

Therapy follow-up appointments typically last 45-60 minutes and are scheduled at 1-4 week intervals, or as clinically appropriate. Therapy is an opportunity for the clinician to help the client better understand him/herself. Therapy involves examining your emotions, environment, and your reactions to occurrences in life in hopes to arm you with healthy coping skills for the future. Counseling can have benefits and risks. Sometimes people experience increased distress as discussing unpleasant aspects of life can cause uncomfortable emotions. On the other hand, ongoing therapy can lead to better relationships, significant reductions in feelings of distress, and development of healthy coping skills.

Whether therapy, medication, or both is recommended, it is important to remember that healing takes time. Being patient, open, and honest about your response to medications and emotions during therapy sessions will help us guide your path to wellness.

Our providers will always do their best to help you achieve your goals, but you may not achieve your desired outcome.

All treatment is strictly voluntary, and you may choose to discontinue treatment at any time.

For your convenience, we offer virtual visits. Using HIPAA-compliant video conferencing services, you will be able to attend your appointment from home, school, work, or any other place.

We do not provide forensic services, such as custody evaluations/recommendations or court-ordered services.

We do not complete paperwork for any organization unless you have been a patient for 6 months or longer or have had a minimum of 6 visits.

We do not prescribe benzodiazepines and because tapering this class of medication can be medically dangerous, we recommend this be done prior to establishing care at our office, ideally by the prescriber who is currently prescribing.  If that’s not possible, we recommend this be done under the medical supervision of a PCP prior to establishing with our practice. 

We do not write letters certifying animals as emotional support animals.

We do not routinely complete disability paperwork. Our goal is to help you attain maximal functioning in your everyday life, and while we understand that short periods of time off work may occasionally be necessary, this is not consistent with our expectations for you.

While it is always our goal to maintain treatment relationships for as long as possible, sometimes it becomes necessary to part ways if a patient’s need for services exceeds what providers at Tranquility can provide. The decision to refer a patient for ongoing care outside Tranquility can be made at any time in the treatment course. Once this decision is made, the patient will be notified by Tranquility staff and a certified letter will be mailed. We will continue to provide emergency care for up to 30 days or until an appointment with another agency can be secured.


We will respect your right to confidentiality. Any confidential information you disclose during treatment shall be held in confidence unless you permit us to disclose such information, or in situations where we are required to disclose such information by law. Exceptions to confidentiality include (but are not limited to): reports of suspected child or elder abuse to the proper authorities, action taken if the patient presents a threat of harm to self or others, responses to court orders or subpoenas for records.

You are agreeing to the disclosure of confidential information to other clinicians involved in your case when your provider feels it is clinically appropriate to do so. This includes the provider who referred you, if applicable. Similarly, if we refer you to another provider for treatment, limited information may be shared during the referral process.

For patients under the age of eighteen (18), both parents have the right to information disclosed in appointments without a release of information. In these cases, we strongly advise you to allow much of what your child says to remain confidential. Even though you are entitled to the information, insisting on it could damage our professional relationship with your child. We will be happy to keep you informed about treatment progression and how you can best support your child at home. Please note, we will always inform you if there are any concerns about your child’s safety or if we feel your child poses a danger to others.

Please be aware that the audio or video recording of any session is not permitted secondary to therapeutic and privacy issues. If an unauthorized recording is made, it is grounds for immediate termination of the therapeutic relationship.

Crisis Situations:

If you are in crisis and need immediate assistance, it is imperative that you take action:
Call 911
Call or Text 988
Visit the nearest emergency room
Call NetCare Access (in Franklin County) at 614.276.2273
Call HelpLine in Delaware County at 211 or 740.369.3316
Call HelpLine in Morrow County at 211 or 419.947.2520
Text HelpLine to 898211
National HelpLine: 800.684.2324
Call the Columbus Suicide Hotline at 614.221.5445
Call the National Suicide Hotline at 800.273.8255