Claudelle R. Glasgow, Psy.D., SEP
(312) 804 – 3079
4225 NE Tillamook St Portland, OR 97213
Addendum to Patient Services Agreement:
For those of you who wish to have Zoom, video conferencing, or phone sessions with
me, please read the following and sign if this is acceptable to you.
HIPAA laws are the laws related to privacy rights of information shared with me as your
clinician, as well as information that gets transmitted to your insurance companies. Some of
the forms you signed early on about privacy rights, Consent to Release Information, etc are
related to this. They are rather extensive and cover issues as varied as how patient and
clinician can communicate among themselves and with others, and the nature of the
As well, we are beginning to be able to communicate via Zoom, video conferencing, and
phone sessions. These types of sessions are often convenient and useful when a face-to-face
session is not possible.
It is necessary that I inform you that even with telehealth laws and guidelines, there is still
the potential threat of hacking and unauthorized access to PHI (personal health information).
In other words, telephone sessions, video conferencing, and Facetime sessions do not have
the same guarantee of privacy as face-to-face sessions in my office.
Please note that your insurance company (with the exception of Medicare) may cover video
telehealth sessions, but as of now telephone sessions are usually not a covered benefit.
Therefore, if you choose a modality not covered by insurance, the full fee will be your