Policies & Guidelines

On becoming a patient:

Initial evaluation:

  • Our first appointment will be a consultation only which generally lasts one hour.
  • Filling out these forms is required prior to our first visit. They help us make the most of your first appointment.
  • Further appointments may be required for me to complete this consultation, before I can conclude my assessment and discuss treatment recommendations.
  • At the end of the initial evaluation or consultation, we will make a mutual decision on whether my practice fits your needs and expectations.
  • I will do my best to provide recommendations that meet your needs, expectations, and abilities. I will not initiate any treatment or prescribe medications if that is not the case.
  • If I cannot meet your needs I will not be able to accept you as a patient.
  • In case you may not agree with my recommendations, and decide we are not a good fit, my initial appointment fees still apply, even if you decide to not continue our relationship.
  • If you miss the initial appointment, it will NOT be rescheduled.

Communication and Collaboration with other providers:

  • I recommend patients have a primary care provider (a family physician or internist).
  • If you have had previous mental health providers, I may find necessary request to communicate with them or obtain records before we begin treatment.
  • If you are seeking a second opinion, I welcome such consultation, but also request to have an opportunity to communicate with your other provider(s).
  • If you are transferring care to me from another provider, please understand that I may not agree with their treatment plan and may not be able to automatically renew the medications you have been receiving.
  • I will however review your past records and history and we will work on the most appropriate treatment plan together.
  • If you don’t agree to have your records sent to me, this is your choice, but in some cases I may not feel comfortable taking on someone’s care without being able to review their records.

Frequency of appointments:

  • The frequency of our appointments will be variable depending on your needs (generally ranging from once a week to once a month)
  • It is expected that every patient is seen in the office, in person, at least once every 3 months.
  • If you have not been seen in over 3 months, your chart will be closed automatically, and I will not be responsible for your care or further prescriptions.

Telemedicine appointments:

  • In some cases I may offer you the option to have appointments by video-conferencing technology for your convenience.
  • This may not be suitable to all patients.
  • If that is something you desire, I do require at least one initial face-to-face evaluation, and one face-to-face visit each year.


  • Please notify me at least a week in advance if you require a medication refill.
  • Because it is not safe for me to continue providing medications without appropriate monitoring, my policy is to only provide refills if you have a future appointment scheduled.
  • For controlled substances (e.g. stimulants for treatment of ADHD) I do not routinely refill them without an appointment.
  • Controlled medications will not be replaced if they are lost or stolen (unless a police report is provided).
  • Controlled medications will not be prescribed earlier than scheduled.
  • If you feel the need to have a different dose of the medication, you must schedule an appointment to review your treatment.
  • Controlled med prescriptions are confirmed by the online state prescription database, as per state requirements, to ensure that duplicate prescriptions are not written by other prescribers.
  • When consulting the Washington Prescription Monitoring Program database, I must enter your name and date of birth, identifying myself as your provider.
  • You are responsible for updating all your physicians of any new medications that are prescribed to you.
  • At times an unscheduled toxicology screen may be necessary during treatment, either to monitor for presence of any illicit substances or confirm compliance with a certain medication.
  • I expect that I will be the only person prescribing psychiatric medications during our treatment.

Prior Authorizations:

  • Many insurance companies require a “prior authorization” for some medications.
  • I may need to charge you for that, as it can be very time consuming (see “Services & Fees” page).


  • Depending on your policy, your insurance may reimburse you for part of the visit cost. Click on “Services and Fees” above for a guide on what to ask your insurance.

Services & Fees:

  • Phone call – less than 5 minutes: no charge
  • Phone calls over 5 minutes, prior-authorization for medications, forms, letters, etc: Pro-rated charge based on an hourly rate of $280.
  • Your insurance will likely not reimburse you for this type of fee.

Cancellations / Missed Appointments:

  • You will not be charged for cancellations made more than 24 hours in advance.
  • You can cancel by sending me an email, or leaving me a voice mail. Do not send SMS texts to my office number, as they will not go through.
  • Cancellations made less than 24 hours in advance are billed at 1/2 the appointment rate.
  • Missed appointments are billed at the same rate as the scheduled length of time of your visit.
  • If you are more than 15 minutes late, I consider that a missed appointment.
  • Your insurance will likely not reimburse you for this type of fee.

No photography or audio recording is permitted in sessions.

Services I do NOT provide:

  • Emotional Support Animal Letters
  • Disability Evaluations
  • Forensic Evaluations
  • L&I assessments
  • Assessments for ability to return to work, ability to own a weapon, ability to drive a certain vehicle, etc.
  • Transcranial Magnetic Stimulation / Electroconvulsive Therapy
  • Suboxone Treatment
  • Couples or Family Therapy
  • Court-ordered treatment, or treatment under the Washington Involuntary Treatment Act (ITA)


  • You have the right to review and obtain a copy of your health information, with limited exceptions. You may request a copy of your records by submitting a written request to Lifestyle Psychiatry M.D., There may be a nominal fee to cover printing/photocopying and shipping costs.

On rare occasions I may also find it necessary to terminate our treatment without your agreement. For example, this may be done if you choose not to comply with treatment recommendations to such an extent that the treatment is ineffective. Treatment may also be terminated if:

  • You fail to keep two appointments: either no-show or less than 24 hours.
  • You fail to return for an in-person appointment at least every 3 months. (If you wish to resume treatment at a later time, a new comprehensive assessment may be necessary.)
  • You fail to participate in or misuse your treatment.
  • You do not agree with my treatment recommendations, despite my best efforts to find a treatment that matches your preferences.
  • You do not pay your bill at the time of each appointment.
  • You engage in any unprofessional, intimidating or threatening behavior.
  • You do not follow through on my treatment recommendations.
  • You see another psychiatrist or physician for management of the same or related condition and do not notify me.
  • I am not comfortable with medications prescribed to you by another provider.
  • You require a higher level of care, or different treatment that I am not equipped to provide.
  • You misuse medications or obtain duplicate prescriptions from other providers.
  • You are suspected of trading, selling or giving away a medication.
  • You make a request for me to misrepresent diagnosis or level of functioning in order to obtain benefits that you are not entitled to.