Informed Consent for Treatment in Florida

Psychiatry

Two Chairs provides psychiatry services, starting with a virtual evaluation appointment with a licensed clinician. Following this initial appointment, your clinician will determine if further evaluation is needed or if you can begin treatment. To assess your physical and mental health, your clinician may order medical and psychological tests. Treatment plans, tailored to your individual needs, may include psychotherapy, medication, and psychosocial interventions. Your clinician will establish your treatment plan and the frequency of your visits.

In compliance with Florida Statute 458.348 (4), if you are referred to Two Chairs by another practitioner, you have the right to be informed about the type of license held by the professional providing your services. Two Chairs utilizes advanced professional practitioners, such as advanced practice nurse practitioners (APRN) and physician’s assistants (PA), to deliver psychiatry services. You acknowledge and agree that your clinician will likely be an advanced professional practitioner supervised by a psychiatrist, and you consent to receiving these services.

Prescribing

Medication can significantly relieve mental health symptoms that affect daily life. If you are enrolled in Two Chairs psychiatry and medication is recommended, your clinician will provide information regarding side effects, interactions, and proper usage. Your clinician may recommend off-label use when appropriate, and will discuss the risks, benefits, and alternatives with you.

Medication therapy is not suitable for everyone, as it requires strict adherence, close follow-up, and sometimes lab tests. You must agree to follow directions and acknowledge the risks and potential side effects. Your compliance will be taken into consideration.

Confidentiality

Your sessions and records are private unless you give us written permission to share them. However, there are a few exceptions required by law, including but not limited to:

• Self-Harm: If there is a serious risk you may hurt yourself.
• Harm to Others: If there is a threat of violence toward another person.
• Abuse: We must report suspected abuse of children or elderly adults.
• Legal Orders: We may have to provide info if a court orders us to do so.
• Court-Ordered Therapy: Confidentiality may not apply in court-ordered therapy or when providing expert reports to an attorney.

To give you the best care, your provider may talk with other experts. Inside Two Chairs, our providers work together to improve your treatment plan. If your provider talks to anyone outside Two Chairs, we will not share your name or any information that identifies you unless you say it is okay.

Coordination of Care with Your Referral

We may work with the provider who referred you to Two Chairs. Privacy laws like HIPAA let us share relevant care details to help with your treatment. We will never share sensitive data like drug use or HIV test results without written permission from you.

Electronic Communications

As part of your care, we may send you different types of messages. These include tips for getting started, reminders for your appointments, and other updates about our services. We send these electronically in three ways: (1) emails to the address you gave us, (2) text messages to your mobile phone, and (3) notifications through the Two Chairs Client App.

If you would like us to contact you in a different way, please send a written request to support@twochairs.com. We will do our best to help with your request.

See more on Electronic Terms of Service here.

Health Information Exchanges

Two Chairs may share your health records through secure networks called Health Information Exchanges (HIEs). These records include treatment history, diagnoses, and related clinical data. This coordination helps Two Chairs and your other providers work together to give you the best possible care. We will never share your information through an HIE for advertising or marketing purposes.

By signing this form, you agree to participate in these health networks, which may include information about mental health or past substance use. If you do not wish to participate, please email compliance@twochairs.com. Once we process your request, we will stop sharing new information through the network; however, any information already shared may remain visible to authorized providers. Opting out will not limit your access to care or change the quality of care you get from Two Chairs.

Complaints

Two Chairs is dedicated to providing you with the highest quality care. If you have concerns about the care you received or any aspect of your experience with us, we encourage you to share them. Your feedback will be reviewed promptly and confidentially, and will not affect your care or treatment. Please email us at complaints@twochairs.com.

All Two Chairs providers hold individual licenses from their state boards. While licensing ensures legal qualifications, it does not guarantee specific results or endorse a particular style of practice. If you have a formal complaint against a provider, you may contact the appropriate state board directly to:

Questions

If you have any questions, talk to your provider or email support@twochairs.com.

If you are experiencing an emergency, crisis, or need immediate assistance, please call 911 or the National Crisis Hotline at 988, or go to your nearest emergency room. Additional crisis resources can be found here