Life Architecture

Form 3-D — Dr. Lisa M Hill

Informed Consent & HIPAA Privacy Disclosure

This document provides important information regarding your rights, the nature of services provided, and how your personal information is protected. Please read carefully before signing.

Informed Consent for Services

By engaging in services with Dr. Lisa M Hill, you are entering into a professional, faith-integrated process designed to support clarity, growth, and meaningful change over time.

This work is faith-integrated in nature, informed by doctoral-level training and clinical experience. It is not licensed psychotherapy and is not provided through state licensure.

The process is collaborative. Sessions are guided by what is most present and relevant, with the goal of understanding patterns, responses, and influences that shape daily life.

Outcomes cannot be guaranteed. Progress is influenced by many factors, including level of engagement, consistency, and circumstances outside of sessions.

You have the right to ask questions, seek clarification, and participate in this process at a pace that is appropriate for you.

Client Rights

As a client, you have the right to:

  • Be treated with respect and professional care
  • Ask questions about the process at any time
  • Make informed decisions about your participation
  • Discontinue services at any time

Confidentiality

Information shared in sessions is kept confidential and handled with care.

There are specific situations where confidentiality may be limited, as required by law. These include:

  • Risk of harm to yourself or others
  • Suspected abuse or neglect of a child, elderly person, or vulnerable individual
  • Court-ordered disclosure

If any of these situations arise, appropriate steps will be taken in accordance with legal and ethical standards.

Use & Protection of Information (HIPAA)

Your personal information is protected and used only for purposes related to your care. This may include:

  • Scheduling and communication
  • Documentation of sessions
  • Administrative or billing purposes

Reasonable safeguards are in place to protect your information from unauthorized access.

Your information will not be shared with outside parties without your written permission, except as required by law or outlined above.

Communication & Electronic Systems

Communication may occur through electronic platforms (such as email or secure systems). While reasonable care is taken, no system can guarantee complete security. By engaging in services, you acknowledge and accept the use of these communication methods.

Acknowledgment & Consent

By signing below, you acknowledge that you have read and understand this Informed Consent & HIPAA Privacy Disclosure, you have had the opportunity to ask questions, and you voluntarily agree to participate in services with Dr. Lisa M Hill.

Typing your name constitutes your electronic signature.