PRACTICE POLICIES

Mindful Sasquatch PLLC

Rendering Provider: Ryan Q Patterson, MA, LMHC

 

Service Address:

14090 Fryelands Blvd, Suite 316

Monroe, WA 98272

Mailing Address:

PO Box 2354

Snohomish, WA 98291-2354

Phone: 425-205-9332

Effective Date: January 27, 2026

HOURS OF AVAILABILITY AND ACCESSIBILITY

I am generally available to respond to phone calls and other communications during regular business hours:

Monday through Friday, 9:00 a.m. to 6:00 p.m. PST, excluding federal holidays and scheduled vacations, which will be communicated in advance when possible.

The preferred method of contact during business hours is by phone with a voicemail message. Please note that I am often in session and may not be immediately available. I make reasonable efforts to return messages within one business day.

While email, secure messaging through the client portal, or limited SMS text messaging may be available, response times for these methods may vary. Policies governing electronic communication are outlined in the Electronic Communication Authorization and Policy.

This practice does not provide 24-hour on-call availability.

CRISIS OR EMERGENCY SITUATIONS

Psychotherapy services provided by this practice are not a substitute for emergency or crisis services.

988 Suicide & Crisis Lifeline: call or text 988 (available 24/7)

Care Crisis Line (serving Snohomish County and the North Sound region): 800-584-3578 (available 24/7)

Non-Imminent Crisis

On occasion, a crisis or urgent situation may arise. I make reasonable efforts to offer emergency appointments when clinically appropriate; however, availability cannot be guaranteed. Emergency appointments may require rescheduling of existing appointments.

If you are experiencing a crisis during business hours, you may attempt to contact me by phone. If I am unavailable and you feel unable to wait for a response, you are encouraged to contact the crisis resources listed above.

Electronic communication (email, secure messaging, or text messaging) must not be used for crisis situations.

Imminent Crisis

If you are in immediate danger to yourself or others, you must call 911, contact your local emergency department, or call or text 988.

After Hours

If a crisis occurs outside of business hours and requires immediate attention, contact 911, the nearest emergency department, or a crisis resource. Messages left after hours will be returned during the next business day.

ELECTRONIC COMMUNICATION

Policies regarding email, secure messaging, and SMS text messaging are outlined in the Electronic Communication Authorization and Policy, which governs appropriate use, limitations, confidentiality risks, and response expectations.

Electronic communication is not monitored continuously and must not be used for emergencies or urgent clinical concerns.

APPOINTMENTS AND CANCELLATIONS

Standard psychotherapy sessions are 50 minutes, unless otherwise scheduled in advance.

If you arrive late to a session, the session will still end at the scheduled time, and you are responsible for the full session fee. Sessions may be considered a no-show if you are more than 30 minutes late without prior communication.

Appointments must be cancelled or rescheduled at least 24 hours in advance. Late cancellations or missed appointments are subject to the full session fee, as insurance and EAP programs do not reimburse for missed sessions.

Clients are eligible for one emergency cancellation per 25 attended sessions, which may be applied to an unforeseen circumstance preventing timely cancellation.

Repeated late cancellations or missed appointments may result in termination of services.

RECORD KEEPING AND HIPAA

A clinical record is maintained for each client and may include demographic information, assessments, diagnoses, treatment plans, attendance, billing records, correspondence, and summaries of services provided.

Psychotherapy notes, when maintained, are kept separate from the clinical record and receive additional protections under HIPAA and Washington State law.

All records are stored securely in compliance with applicable privacy laws. For additional information, please refer to the Notice of Privacy Practices.

SOCIAL MEDIA AND PROFESSIONAL BOUNDARIES

To protect client confidentiality and maintain professional boundaries, I do not accept friend or contact requests from current or former clients on social media or professional networking platforms (e.g., Facebook, Instagram, LinkedIn).

This policy is intended to protect your privacy and the integrity of the therapeutic relationship. Questions about this policy are welcome.

TELEHEALTH AND PHONE SESSIONS

Telehealth services may be available when clinically appropriate and are governed by a separate Telehealth Agreement.

Telehealth services are provided in accordance with Washington State standards of care and may involve limitations related to technology, environment, and assessment.

Phone sessions may be available by arrangement. Coverage for phone sessions varies by insurer and is not guaranteed. Financial responsibility for phone sessions is outlined in the Financial Agreement.

Telehealth and phone sessions are not appropriate for emergency situations.

WRITING LETTERS, FORMS, AND LEGAL MATTERS

On occasion, clients may request letters or documentation verifying participation in treatment or diagnosis. Such letters are limited in scope and provided at the clinician’s discretion.

It is the policy of this practice not to complete forms or documentation intended to establish disability status, legal determinations, workplace accommodations, or eligibility for benefits, including but not limited to FMLA, Labor & Industries, workers’ compensation, or disability determinations. Clients are encouraged to consult their primary care provider or appropriate specialist for such matters.

This practice does not voluntarily participate in legal proceedings, custody disputes, or court testimony on behalf of clients, and will respond to subpoenas or court orders only as required by law. If participation is compelled by a valid subpoena or court order, professional time associated with such participation will be billed in accordance with the Financial Agreement.

LIMITS OF CONFIDENTIALITY

As a general rule, information you share in treatment, and the fact that you are a client of this practice, is confidential and will not be disclosed without your written authorization, consistent with RCW 18.225.105, chapter 70.02 RCW, and HIPAA. Washington State and federal law establish specific exceptions to confidentiality, including the following:

1.      Mandatory reporting: I am required by law to report suspected abuse, neglect, or abandonment of a child (chapter 26.44 RCW) and suspected abandonment, abuse, neglect, or financial exploitation of a vulnerable adult (chapter 74.34 RCW).

2.      Imminent danger: I may disclose information if I reasonably believe disclosure will avoid or minimize an imminent danger to your health or safety or the health or safety of another person.

3.      Legal proceedings initiated by the client: if you bring charges or a claim against me, the confidentiality privilege may be waived to the extent necessary to respond.

4.      Regulatory oversight: I must respond to a subpoena from the Secretary of the Department of Health relating to a complaint or report under RCW 18.130.050.

5.      Other disclosures permitted or required by law, including certain disclosures of health care information under chapter 70.02 RCW and HIPAA (for example, for treatment, payment, and health care operations, as described in the Notice of Privacy Practices).

Additional detail regarding how your health information may be used and disclosed is provided in the Notice of Privacy Practices. Confidentiality considerations specific to couples, families, and minors are described below.

CONFIDENTIALITY FOR COUPLES, FAMILIES, AND MINORS

When providing couple or family therapy, the identified client is the relational unit. No individual member holds a separate confidential relationship with the therapist.

Information disclosed by one member of a couple or family may be shared with other participating members if clinically relevant to the well-being or functioning of the relational unit. Clinical judgment will be used on a case-by-case basis.

Washington State law grants minors aged 13 and older certain rights to confidentiality. These rights and limitations will be discussed as applicable. Parents or guardians paying for services are entitled to billing information only, unless otherwise authorized or required by law.

All confidentiality considerations are discussed during the initial session.

CHANCE ENCOUNTERS IN PUBLIC

To protect your confidentiality, I will not initiate contact or acknowledge you if we encounter one another in public. You are free to initiate contact if you choose. If contact occurs, I will not identify you or disclose the nature of our relationship to others.

ETHICAL DECISION MAKING

This practice is committed to conducting all professional activities in accordance with the American Counseling Association (ACA) Code of Ethics (2014) and the laws and rules governing licensed mental health counselors in Washington State, including chapter 18.225 RCW, chapter 246-809 WAC, and the Uniform Disciplinary Act (chapter 18.130 RCW).

Consistent with Standard I.1.b of the ACA Code of Ethics, when faced with an ethical dilemma that is difficult to resolve, the clinician will engage in a carefully considered ethical decision-making process using the model published by the American Counseling Association: Forester-Miller, H., & Davis, T. E. (2016). Practitioner’s Guide to Ethical Decision Making (Rev. ed.). American Counseling Association. This model consists of the following seven steps:

1.      Identify the problem, including the nature and scope of the ethical concern and the parties affected.

2.      Apply the ACA Code of Ethics and all applicable Washington State and federal laws and regulations.

3.      Determine the nature and dimensions of the dilemma, guided by the foundational moral principles of autonomy, nonmaleficence, beneficence, justice, and fidelity; by relevant professional literature; and by consultation with colleagues, supervisors, professional associations, or legal counsel as appropriate.

4.      Generate potential courses of action.

5.      Consider the potential consequences of all options for all parties involved and determine a course of action.

6.      Evaluate the selected course of action to ensure it does not create new ethical concerns, applying the tests of justice, publicity, and universality.

7.      Implement the course of action and monitor the outcome.

Precedence of law. Where Washington State or federal law imposes specific obligations — including, without limitation, mandatory reporting of suspected abuse or neglect of children (chapter 26.44 RCW) or vulnerable adults (chapter 74.34 RCW), the confidentiality provisions and exceptions of RCW 18.225.105 and chapter 70.02 RCW, HIPAA, and disclosures reasonably believed necessary to avoid or minimize imminent danger to health or safety — those legal obligations take precedence and will be followed.

Consultation and documentation. Ethical decision-making, including the steps taken and any professional consultations obtained, will be documented in the clinical record as appropriate, consistent with the ACA Code of Ethics and the record-keeping requirements of WAC 246-809-035. Consultations are conducted in a manner that protects client confidentiality; identifying information is not disclosed without authorization unless permitted or required by law.

Clients who have questions or concerns about the ethics of any aspect of their care are encouraged to raise them directly with the clinician at any time. Information about filing a complaint is provided in the Complaints or Disputes section of this document.

COMPLAINTS OR DISPUTES

If concerns arise regarding treatment, direction, or policies, you are encouraged to discuss them directly with me.

You may also contact the Washington State Department of Health regarding professional concerns. The department can provide a list of the acts of unprofessional conduct described in RCW 18.130.180 and information about the health professions complaint process: Washington State Department of Health, Health Systems Quality Assurance Complaint Intake, P.O. Box 47857, Olympia, WA 98504-7857; phone 360-236-4700; email HSQAComplaintIntake@doh.wa.gov. Ethics concerns may also be directed to the American Counseling Association.

Unresolved financial matters may be addressed through appropriate collection processes consistent with the Financial Agreement and applicable law.

TERMINATION OF SERVICES

Termination of therapy may be initiated by either party. Therapy may be terminated if treatment is no longer clinically appropriate, if attendance or payment obligations are repeatedly unmet, or if the clinician determines they are unable to provide appropriate care.

Termination will be discussed whenever possible, and referrals will be provided as appropriate.

Failure to schedule or attend sessions for three consecutive months, without prior arrangement, may result in administrative discharge.

ACKNOWLEDGEMENT

By electronically acknowledging this document, you confirm that you have read, understood, and agree to the Practice Policies of Mindful Sasquatch PLLC.

Version date 7/16/2026