The Rock Counseling Group - Champaign IL

Patient Agreement and Financial Responsibility

The Rock Counseling Group is a business facility where a number of mental health professionals practice. Each therapist is part of this group. Your contract for services is with The Rock Counseling Group. Although you will be assigned to a specific therapist within our group, there may be occasion for you to see one or more members of this group. The information below applies to all therapist employed by The Rock Counseling Group.


Rights and Risks:

  • You may ask questions about any aspect of the counseling process.
  • If you have been referred by a court or state agency, you have the right to divulge only what you want to be included in a report.
  • Therapy is most effective when you are open and can speak honestly about your emotions and experiences.
  • Therapy may include talking about emotionally provoking subjects and scenarios.


  • Information shared by you in session will be kept confidential.
  • Information will not be released without your written consent, except for professional consultation if needed and unless required by law.
  • All therapists are required by law to disclose information pertaining to suspected child abuse, the inability to care for one’s basic needs for food, clothing or shelter, and threatened harm to oneself or others.
  • The court may subpoena counseling records.
  • It is understood that information regarding treatment and diagnosis may be provided to an insurance company.
  • You may want to discuss further limits or exceptions of confidentiality.


  • All office visits are by appointment and may be scheduled through the office manager or your counselor directly.
  • Please arrive on time, as you use up your own time when you arrive late for an appointment. The usual length of an appointment is 45-60 minutes.
  • Late cancellation (less than 24 hours before) and/or no-show appointments are billed to the client for the $35.00. In the case of illness, please notify us no later than 8:30 a.m. the day of the appointment. Please leave a message if you get voice mail. If your appointment is cancelled or missed, contact the office for a new appointment time, if your therapist has an opening within the same week of you normally scheduled appointment the cancellation fee will be waived
  • Insurance companies will not pay for no-show charges or late cancellation charges or for telephone consultations and will be charged at a proration of the hourly fee for all consultations in person or by phone that are over 5 minutes in length.


  • The client portion (co-pay/Co-insurance) of fees is expected at the time of service. We accept cash, check, flexible spending account cards, and credit cards. For your convenience we can put your flexible spending or credit card on file for repeated use at each session. If you would like for us to do so, please complete the authorization to charge credit card form.
  • Your health insurance may help you recover some of your counseling costs. Most group policies, but few individual policies cover outpatient psychotherapy. Please verify with your company the amounts of coverage for outpatient psychotherapy by licensed professionals. If your policy requires preauthorization to receive services, we will assist prior to your first session. Although our office will assist as much as possible to ensure you are aware of you insurance benefits, it remains your primary responsibility.
  • Insured clients are expected to take care of their fees as services are rendered. Our office will bill your insurance company for services provided. You will receive a statement each month reflecting any balance due on your account. This office cannot accept responsibility for negotiating a settlement on a disputed claim. You are responsible for payment (and unpaid insurance claims) on your account.
  • Clients paying on a cash basis, and not billing any insurance company are expected to pay in full at time of service unless a payment plan has been previously arranged and agreement signed.
  • Except in the case of minors or when other arrangements are made, the person receiving the counseling service is financially liable.
  • Accounts 90 days in arrears will be turned over for collections.
  • Any change in my financial situation I will discuss with my therapist. In the event you find it necessary to change mental health providers and require records to be sent from The Rock Counseling Group your account will need to be paid in full.

Counseling services

Children, adolescents, families, and individuals can all benefit from a helping hand and a listening ear at certain times that can help provide insight, support, and new strategies for all types of life challenges.


Even highly motivated, upwardly-mobile, educated, generally healthy people can sometimes use a helping hand to make their lives even better! The Rock helps you develop leadership skills that will not only grown your career, but enhance your life.

201 West Springfield Avenue, Suite 1201 Champaign, Il 61820


1002 Commercial Drive, Suite 2, Mahomet, Il 61853

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The Rock Counseling Group - Champaign IL


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