Office Policies

Updated April 2022

Cancellations and Missed Appointments (“no shows”)

Your appointment time is reserved especially for you. We do not double book appointments so that we can give each patient our full, undivided attention for the entire appointment time. If you need to cancel your appointment with us, we ask that you give us at least 24 hours of notice so that another patient in need might be able to use that appointment time. If you fail to cancel your appointment 24 hours in advance, or you miss your appointment, the following fees will be applied to your account:

First late cancellation: no charge

Subsequent late cancellations: a $35 fee will be billed to your account and must be paid before additional appointments can be scheduled

First no show: no charge

Second no show: a $50 fee will be billed to your account and must be paid before additional appointments can be scheduled

Third (or more) no show: a $100 fee will be billed to your account and must be paid before additional appointments can be scheduled

Please note that insurance does not cover the above fees. Additionally, if you have 3 or more no shows or late cancellations in a 12-month period, you may be subject to dismissal from Tranquility Psychiatry and Counseling Services.

We understand that emergencies arise, and we will consider these on a case-by-case basis.

Patients who are prescribed controlled substances (i.e., stimulants) and who late cancel or no show for an appointment will not receive refills until next seen by their medication provider.

For our part, we will make every effort to provide you with as much notice as possible should a provider need to be out of the office unexpectedly, and we will work to reschedule your appointment in a timely fashion.

Prescription Refills

Your medication provider will always try to send in enough medication refills to last until your next scheduled appointment. If you think you are in need of a refill, please call the pharmacy to be sure you do not have a prescription on file. In the event that you need a refill between appointments, please fill out the refill request form available on our website. Please try to provide 24-48 hours of notice of your need for medication as we don’t ever want you to go without your medication. The prescription refill forms will be monitored on weekends to ensure refills can be sent within the 24-48 hour timeline.

Contacting Us

Phone hours are Monday to Thursday, 7:00AM to 5:00PM and Friday, 8:00AM to 12:00PM. Most routine calls are returned within 48 hours during the above stated business hours.

Please note, Tranquility Psychiatry and Counseling Services is not a 24/7 emergency provider and our messages are not monitored after hours.

If you are in crisis and need immediate assistance:
Call 911
Visit the nearest emergency room
Call NetCare Access (in Franklin County) at 614.276.2273
Call HelpLine
Delaware County: 211 or 740.369.3316
Morrow County: 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

Professional Boundaries and Social Media

Your relationship with us is a professional and therapeutic one. In order to preserve this relationship, it is important that we not have any other type of relationship with you during or after completion of treatment. Personal and/or business relationships can undermine the effectiveness of the therapeutic relationship and cause professional judgments to be compromised. Our licensing boards and professional organizations advise that the patient and the clinician should not be “friends” on social media platforms, and we want to abide by that advice.

Patient Etiquette:

Disrespectful and/or abusive behavior or harassment towards Tranquility employees will not be tolerated, and patients will be immediately terminated from the practice should this occur.

Billing, Payments, and Insurance Reimbursement

If you have an in-network health insurance policy, Tranquility Psychiatry and Counseling Services will file claims for services rendered. Many insurance policies provide some coverage for mental health treatment. We will fill out forms and provide you with whatever assistance we can in helping you receive the benefits to which you are entitled; however, you (not your insurance company) are responsible for full payment of our fees. If you have insurance co-pays, co-insurance payments, or need to meet your deductible, it is required that you pay these fees up front. It is very important that you find out exactly what mental health services your insurance policy covers.

You should also be aware that your contract with your health insurance company requires that we provide them with information on the services that we provide to you. We are required to provide a clinical diagnosis. Sometimes we are required to provide additional clinical information such as treatment plans or summaries, or copies of your entire clinical record. In such situations, we will make every effort to release the minimum information that is necessary for the purpose requested. This information will become part of the insurance company files, and it is important to note that we have no control over what they do with this information.

Full payment is due for each session at the time it is held. You may pay by check or credit card. If your check does not clear, you will be responsible for any additional fees the bank charges, and will need to pay for further sessions by credit card. If your account has not been paid for more than ninety days, we have the option of using legal means to secure the payment and you consent to our doing that. This may involve a collection service. In the event that a collection service becomes involved, we will only release the minimum amount of information necessary to collect what you owe.

Please note, an option under federal law allows you to stop information from going to your insurance company. You must request this at each appointment and you must agree to pay for the appointment in full.

Current Fee Schedule:
Initial Medication Management Consultation: $250
Follow-up Medication Management Appointment: $155
Initial Therapy Consultation: $150
Follow-up Therapy Appointments: $85

Charges for phone calls and paperwork:

Phone calls at your request lasting more than five minutes, such as consults with other professionals or family members, may be charged at the normal rate for a clinical hour, prorated in ten-minute increments. This same rate will also be applied for time involved in the preparing and writing of requested treatment summaries, letters, or paperwork other requests. Insurance companies do not typically pay for these services. The total cost for paperwork or phone calls will depend on the complexity of the call/form/paperwork requested. If you have questions regarding this rate, please clarify it with our staff at the time of your request.

Tranquility staff 10-minute increment rate: $25

Information for Parents who are Divorced or Separated:

If your child is under eighteen (18) years of age, we will need to have a copy of court documents or custody papers that prove you are the legal guardian. If there is a shared parenting agreement in your custody agreement, we will also need a copy of this to determine what the legal agreement is regarding your child’s mental health services. If both parents are involved in parenting the child, both parents must sign a consent to begin treatment. It is beneficial for both parents to be involved in treatment in some capacity. Decisions will always be based upon what is in the best interest for the child.

Billing statements will only be sent to one parent/guardian. It is the responsibility of the parents/guardians to determine how to pay or split payment for treatment.


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.