Disclosure
Therapist Disclosure Statement
California Business and Professions Code §728 requires that licensed therapists provide the following information to clients.
License and Credentials
| Name | Faith Haas |
|---|---|
| License type | Licensed Marriage and Family Therapist (LMFT) |
| License number | 163370 |
| License expiration | 05/31/2028 |
| Issuing board | California Board of Behavioral Sciences (BBS) |
| Education | MS Marriage and Family Therapy/Counseling, California State University Fullerton, 2023 |
| Years licensed | 1 |
License status can be verified at: BreEZe – California Department of Consumer Affairs
Services Offered
Faith Haas Therapy provides psychotherapy for adults, children, couples, and families. Services include:
- Individual therapy (in person and via telehealth)
- Couples and family therapy (in person and via telehealth)
- Therapeutic approaches including cognitive-behavioral therapy (CBT), Internal Family Systems (IFS), attachment-based work, and somatic approaches
- Specialty areas including trauma, anxiety, life transitions, depression, relationship concerns, grief & loss
Fee Structure
Session fee: $150 per 50-minute individual session; $175 per 50-minute couples and family session.
Fees are due at the time of service unless other arrangements have been made in writing.
Insurance and out-of-network: Faith Haas Therapy accepts some insurance plans. I can also provide a superbill (detailed receipt) you may submit to your insurance company for potential out-of-network reimbursement. Please contact your insurance company prior to your first session to understand your mental health benefits.
Sliding scale: A limited number of sliding-scale slots are available for clients with financial need. Please contact me directly to discuss.
Cancellation policy: Cancellations made less than 24 hours before a scheduled appointment are subject to a late cancellation fee. Please contact me for the current fee amount.
Good Faith Estimate
Under the No Surprises Act (federal law effective January 1, 2022), you have the right to receive a Good Faith Estimate of the expected cost of your care before your first session if you are uninsured or choose not to use insurance.
A Good Faith Estimate is not a contract. It provides an estimate of costs for your care over a 12-month period. Actual costs may vary.
To request a Good Faith Estimate before scheduling, contact us at info@faithhaas.com or (714) 257-5101.
If your actual bill exceeds the Good Faith Estimate by more than $400, you may dispute the bill through the federal patient-provider dispute resolution process. For more information, visit: www.cms.gov/nosurprises
Telehealth Services
Faith Haas Therapy offers services via telehealth (video and telephone) in addition to in-person sessions. Telehealth services carry certain differences from in-person care that will be explained during your initial session. Use of telehealth services requires a signed Informed Consent for Telehealth, which will be provided during intake.
Telehealth services are available to clients physically located within the State of California at the time of each session.
Confidentiality and Limits of Confidentiality
Your sessions are confidential. California law and professional ethics require that therapists maintain client confidentiality, with specific exceptions required or permitted by law. Key exceptions include:
- Mandatory reporting: If there is reasonable suspicion of child abuse, elder abuse, or dependent adult abuse, we are required by law to report to the appropriate authorities (California Penal Code §11166; Welfare and Institutions Code §15630).
- Duty to protect: If you make a credible threat of serious, imminent harm to an identifiable third party, we may be required to warn that person and/or notify law enforcement (California Civil Code §43.92).
- Imminent risk to self: If you present an imminent risk of harm to yourself, we may take steps to protect your safety, including seeking an emergency psychiatric hold.
- Court orders: Records may be disclosed pursuant to a valid court order or subpoena.
- Licensing board investigations: Records may be subject to review in connection with a licensing board proceeding.
For a full description of your privacy rights and how your health information is used and disclosed, please review our Notice of Privacy Practices.
Client Rights
As a client in California, you have the right to:
- A dignified, respectful therapeutic relationship free from discrimination
- Receive information about your treatment and participate in treatment decisions
- Receive a copy of your records (subject to applicable law)
- Request a referral to another provider at any time
- File a complaint with the California Board of Behavioral Sciences if you believe your rights have been violated
California Board of Behavioral Sciences
- 1625 N. Market Blvd., Suite S-200
- Sacramento, CA 95834
- Phone: (916) 574-7830
- www.bbs.ca.gov
Complaints
If you have concerns about your treatment, please first discuss them directly with Faith Haas. If concerns are not resolved to your satisfaction, you may file a complaint with the California Board of Behavioral Sciences using the contact information above.
For questions, contact:
- Faith Haas, LMFT
- info@faithhaas.com
- (714) 257-5101