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Terms & Conditions

 

Terms & Conditions

Effective Date: January 1, 2025

Welcome to Equilibrium Mental Health Services. These Terms and Conditions (“Terms”) govern your access to and use of our website and telepsychiatry services. By accessing or using our services, you agree to be bound by these Terms. If you do not agree, please do not use our services.

 

Effective Date: January 1, 2025

Thank you for choosing Equilibrium Mental Health Services. These Terms of Service Agreement (“Terms”) outline the rules for using our online website and telepsychiatry offerings. When you access or utilize our services, you consent to comply with these Terms. If you disagree, kindly refrain from using our services.

Equilibrium Mental Health Services offers online mental health support from credentialed professionals. This service shouldn’t replace urgent medical attention. If you’re facing a medical or mental health crisis, please immediately dial 911 without delay or head safely to your nearest emergency department.

To access our services, you need to be at least 18 years old, or have written permission from a parent or legal guardian. We serve clients residing in states in which our psychiatric providers are licensed to practice.

Your confidentiality matters to us. All patient medical details are protected by the Health Insurance Portability and Accountability Act (HIPAA). Please see our Privacy Policy for more information on how we collect, use, and protect your personal and health data.

 

Learn more about how we gather, utilize, and secure your personal and health information.

You’re expected to arrive promptly for scheduled sessions. If you need to cancel or reschedule, please give at least 24 hours’ notice. Late cancellations or no-shows may result in a fee, in line with our appointment policy.

You’re responsible for paying for all services provided. We welcome both insurance and out-of-pocket payments. Before treatment begins, we’ll outline fees, coverage, and payment details. Unless we’ve made another arrangement, payment is expected at the time you receive care.

You must not use this website for any strictly illegal purpose or attempt to unlawfully access any unauthorized part of it. We retain the right to limit or terminate your access if any of these Terms are breached.

Equilibrium Mental Health Services disclaims responsibility for any direct, indirect, incidental or consequential damages caused by using or inability to access our services, including problems that may occur due to telehealth platform outages or disruptions.

We retain the right to modify or adjust these Terms at any time. All updates become effective immediately upon posting to this page. Your continued use of our services after any current revisions signifies your acceptance of the updated Terms.

These Terms shall be governed by and construed in accordance with the laws of the state in which our principal office is located, without regard to its conflict of law principles.

These Terms will be governed and interpreted in line with the laws of the state in which our primary office is situated, without taking into account any conflict of laws provisions.

If there are any questions about these Terms, please contact us at:

Equilibrium Mental Health Services
Email: Equilibriummhs@gmail.com
Phone: 786-247-1308
Website: https://www.equilibriumpsychiatry.com/

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14221 SW 120th St, Suite 221
Miami, FL 33187
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Terms and Disclaimer for Appointment Request Form

Privacy Notice and Consent

By submitting this form, you acknowledge and agree to the following:

Protected Health Information (PHI)

The information you provide may constitute Protected Health Information (PHI) under the Health Insurance Portability and Accountability Act (HIPAA). We are committed to protecting your privacy and maintaining the confidentiality of your health information in accordance with federal and state laws.

Information Collection and Use

  • Information submitted through this form will be used solely for appointment scheduling and initial assessment purposes

  • Your information may be accessed by authorized healthcare providers and administrative staff involved in your care

  • We will not share your information with third parties without your written authorization, except as required by law

Security Measures

  • This form is transmitted through encrypted, HIPAA-compliant technology

  • Your information is stored on secure servers with restricted access

  • We maintain physical, electronic, and procedural safeguards to protect your PHI

Your Rights

You have the right to:

  • Request access to your health information

  • Request amendments to your health information

  • Request restrictions on how your information is used or disclosed

  • File a complaint if you believe your privacy rights have been violated

Consent for Communication

By providing your contact information, you consent to receive appointment-related communications via the methods you specify (phone, email, or text). You may revoke this consent at any time.

 

Important Disclaimers

Emergency Situations

This form is NOT for emergency situations. If you are experiencing a mental health crisis, suicidal thoughts, or any psychiatric emergency, please:

  • Call 911 immediately

  • Go to your nearest emergency room

  • Contact the National Suicide Prevention Lifeline at 988

  • Call your local crisis intervention team

No Provider-Patient Relationship

Submitting this form does not establish a provider-patient relationship. A therapeutic relationship begins only after you have been accepted as a client and have attended your first appointment.

Response Time

While we strive to respond within one business day, this form should not be used for urgent matters requiring immediate attention. For urgent concerns, please call our office directly.

Technical Limitations

Although we use secure technology, no method of electronic transmission is 100% secure. By using this form, you acknowledge this inherent risk.

Age Requirements

If you are under 18 years of age, a parent or legal guardian must provide consent before we can schedule your appointment.

Contact Information

For questions about this privacy notice or to exercise your rights, please contact:
Office Phone: +1 (786) 247-1308
Email: equilibriummhs@gmail.com

By clicking “Submit” below, you acknowledge that you have read, understood, and agree to these terms and conditions.