At Upper Valley Behavioral Health, we value our clients and their loved ones. We have designed our policies to provide safe and holistic care. Please take the time to review our policies so that we may serve your needs in a more effective manner.

Appointment Policy

Clients that have not been seen by our clinic for over 3 months will be required to perform another psychiatric evaluation.

To be certain that we schedule your appointment correctly, we will be asking questions about the nature of the problem or illness.

Children & Adolescent Policy

Clients 17 and under must be accompanied by an adult at all times.

Disability Policy

We do not assist our clients with obtaining extended leave of absences due to mental health conditions.

Our clinic does not assist clients with federal disability claims, including those administered through the VA and the Social Security Administration. However, we are more than happy to release your records to the VA or SSA if you so authorize.

Divorced or Separated Parents Policy

We will only deny a parent’s access to medical records or office visits if there is a confirmed, documented court order. We must have a copy of this court order on file in the child’s medical records. It is the responsibility of the parent or legal guardian to provide us with the court order.

If we do not have possession of a valid court order on file with our clinic, either parent or legal guardian can bring the child into the clinic, or sign the “Consent to Treat” form that authorizes other individuals to bring the child to the clinic, be present during the visit, and consent to any treatment during the visit. We cannot limit or restrict a parent or legal guardian’s rights to participate unless we have been provided a valid court order.

It is both parents’ responsibility to communicate with one another about the patient’s care, clinic visit dates and any other pertinent information relevant to the patient. It is not the responsibility of Upper Valley Behavioral Health Corp. to communicate visit information to each parent or legal guardian separately. Our providers will not call the non-attending parent or legal guardian following visits.

Emergency Policy

If you have an emergency after hours, please call 911 or proceed to the nearest emergency department. Routine questions about mild symptoms, prescription refills and appointments should be conducted during normal business hours.

Insurance Policy

Clients must present a copy of a current and valid insurance card at every visit.

Most insurance plans require referrals from your primary care provider before you can be seen by a participating specialist. We require at least 72 business hours for processing referrals and are not allowed to back date any referral request.

If we do have a contractual relationship with your insurance carrier, you will be responsible for your entire bill at the time of service. We will provide a copy of your bill, at each visit, so you will be able to file your claim with your insurance company. If you change insurance, you will be responsible for your entire amount at the time of service unless payment is pre-approved.

Medical Records Policy

Please carefully review Upper Valley Behavioral Health Corp’s Notice of Privacy Practices, which sets forth the release of medical records and other protected health information.

Non-Discrimination Policy

In accordance with all applicable State and Federal Laws, Upper Valley Behavioral Health Corp. does not discriminate against patients on the basis of race, color, national origin, sex, disability, sexual orientation or other protected classification.

No-Show & Missed Appointment Policy

A “no-show” is an appointment (1) for which you do not show up; or (2) that you change or cancel less than 48 hours (not including weekends and holidays) before your scheduled appointment time.

WE DO NOT OFFER GRACE PERIODS. We recommend you connect 5-10 minutes before your scheduled appointment time. If you connect after your scheduled appointment time, you will be required to pay the no-show fee and you will be rescheduled for a different time/date.

There is a $50 charge for each no-show. The fee is charged to the patient, not the insurance company, and is due BEFORE scheduling another appointment.

The no-show fee is subject to change and you will be notified through electronic means including but not limited to: text and/or e-mail. We recommend you periodically review our web-site for the latest information on our fee schedule.

Clients who no-show more than 2 times may be terminated as patients of the practice.

As a courtesy, when time allows, we make reminder calls for appointments. If you do not receive a reminder call or message, the above policy will remain in effect.

Payment Policy

When you seek our services and have insurance, you will be responsible for your co-payment prior to seeing your provider. We then bill your insurance for the services rendered, and if there are any charges not covered by your insurance, these become your responsibility. You will receive a statement for those charges. Any account which is not paid in full within 30 days of the invoice date must be paid in full before any further services can be rendered.

Prescription Policy

No prescription refills will be authorized over the phone. Patients requiring medication refills are required to schedule an appointment and see their healthcare professional.

Our clinic does not offer written prescriptions. All prescriptions will be securely transmitted electronically. If you plan to use a military pharmacy for your prescriptions, they are unable to receive electronic prescriptions for controlled substances from civilian healthcare providers. We will not provide a written prescription. Please plan accordingly.

By law, ADHD/ADD stimulant medications cannot be refilled. Our practice does not future-date prescriptions.

Medication samples are provided in the sole discretion of Upper Valley Behavioral Health and are often unavailable.

Many insurance companies require prior authorization on certain medications. Please have your pharmacy fax the notification to our office and we will respond to the request from your insurance company. Keep in mind that prior authorization requests can take from 2-5 business days to process after we send the information to your insurance carrier. Upper Valley Behavioral Health is not responsible for your insurance company's decision of coverage.

All medications have risks and side effects. Carefully review all disclosures provided by your pharmacy.

Respectful Behavior Policy

Our policy is to treat everyone who enters/calls our clinic with the kindness and respect that we would like to receive ourselves. We understand that sometimes upsetting situations occur. However, we have a zero tolerance policy for patients/parents/guardians who use curse words, threatening, and/or vulgar language with our staff. If this occurs, you will be discharged from our clinic. 

Talk Therapy Policy

Our healthcare professionals engage in brief supportive psychotherapy.

We do not have therapists or counselors.

Clients that feel they need more intensive therapy services should seek services with a licensed therapist.

Compliance Policy

Clients are required to meet all of the requirements of the treatment plan. Upper Valley Behavioral Health reserves the right to immediately terminate its relationship with any patient that: (1) does not follow the treatment plan; (2) fails to disclose all medication prescribed by other healthcare providers; (3) utilizes illegal narcotics or other medications; (4) obtains psychotropic medications from another healthcare provider; (5) engages in self-destructive behavior; and (6) for any other lawful reason.

Visitor Policy

Adult Patients

No visitors allowed during visit.

Patients 17 & Under

Two parents/guardians allowed during visit.
No other minor children allowed during visit.
Minor children must be supervised at all times in waiting area.

No exceptions will be made.

We may update these terms at any time and may notify you of such updates by any reasonable means, including by posting a notice of the updated terms on our web-site, text, and/or e-mail. You agree that we may update these terms from time to time without notice, and you agree to review these terms concurrent with your use of the services to identify any updates thereto. The last date of any updates will appear at the top of these Terms. YOUR CONTINUED USE OF THE SERVICE FOLLOWING ANY UPDATES TO THESE TERMS SHALL CONSTITUTE NOTICE AND ACCEPTANCE OF THE UPDATED TERMS.

Join our Newsletter