I, the undersigned, grant Lauren Davisson permission to treat myself or legal guard in her capacity as an Speech and Language therapist.
Speech Therapy Terms & Conditions
Thank you for utilizing the services of my practice. I am committed to providing a quality and research-based speech therapy program for your child. In order to do so your commitment and participation is required.
Your child’s therapy program will be individually developed to target his/her specific needs. Commitment to the program is key in terms of achieving progress within therapy.
A time frame for therapy is difficult to establish and is affected by: attendance to therapy, compliance with home programs and stimulability to therapy techniques. You are encouraged to allow your child the necessary amount of time, as recommended by the therapist.
As the parent/guardian, you are encouraged to be actively involved in the therapeutic process. Regular contact with your child’s therapist is encouraged to ensure that you know what therapy is being done with your child. Contact can be made via email/SMS/WhatsApp/telephonic calls (during working hours).
Punctual arrival is the responsibility of the parent, as any time lost due to late arrival is forfeited and full rates will be charged.
Progress reports are done annually or on request by the parent/guardians or school and will be charged for.
One month’s written notice of termination of therapy is required so that there is enough time to terminate well with your child, as well as prepare for adequate hand-over and referral. A discharge report will be provided when therapy is terminated and will be charged for.
Therapy sessions can be attended by parents/guardians or other important parties, but only if it does not hinder the therapeutic process.
Feedback on therapy sessions will occur verbally or electronically and will be charged for.
Assessments usually involve a 1 hour assessment session, a written report and a feedback session with the parent.
These are conducted prior to initiating the therapy program and thereafter on an annual basis. These form an important part of the therapy process, enabling the therapist to plan a program adequately based on the child’s performance and requirements.
Should your child not cope with a comprehensive assessment, diagnostic therapy will be conducted where the assessment will be conducted over three 40-minute therapy sessions. A written report will be provided and a feedback session with the parent will be conducted.
Assessments, parent feedback sessions and reports are charged for accordingly, based on the stipulated rates.
Confidentiality of Information
As the parent/guardian you:
Accept that the following professionals; school, teacher, psychologist, physiotherapist, teacher, family doctor/occupational therapist, etc. may be kept informed of the therapy process on verbal/written approval from me as the parent/guardian.
Realise that the information exchanged in therapy is treated as strictly confidential by the therapist as well as any other involved professionals. The therapist, however, may divulge information to sources deemed necessary in the interest of the child.
As parent/guardian, hereby take responsibility in providing the school with a copy of the report received from the therapist following the parent feedback.
Acknowledge that your child’s personal information will not be shared with anyone else, or any other business (such as an insurance company, your employer, a lawyer) without written consent, except where therapist may be under a legal obligation to do so.
Acknowledge that your child’s records will be kept up until they are 18 years of age or 21 years of age (as special needs child) as per the Patient’s Rights Charter. Patients will be notified if these records will be removed/changed or destroyed. All patient records (in hard-copy or electronic) are kept in locked locations.
I Acknowledge that Lauren Davisson makes use of smeMetrics billing software and that all invoices and statements will be generated using smeMetrics.
I understand and acknowledge that Lauren Davisson makes use of Kitrin (Pty) Ltd for the administration of her practice which includes but is not limited to invoicing, allocation of payments and following up on overdue accounts. I agree that Kitrin may contact me with regards to any invoice, statement, payment and or appointment related query.
In order to provide your child and you with the best therapy, it is important that we have as much information as possible concerning your child’s health, social-emotional, and educational functioning. This includes information pertaining to any medical, psychological, educational, or any other professional testing or reporting.
To obtain and share this information, we require your express, informed consent in writing. Most instances of information sharing will be with your child’s teacher or any other health professional (e.g. Educational Psychologist, Speech and Language Therapist, Neurologist etc.). Subject to the information sharing as provided for above, your child’s information will be kept confidential as guided by the HPCSA Code of Conduct for Healthcare Professionals and our Privacy Notice
I understand that Lauren Davisson’s consulting fees are in accordance with the Board of Healthcare Funders of South Africa. I accept that sessions are charged at medical aid rates and are subject to annual increase.
Accounts are reflected on an invoice which will be emailed monthly.
Each monthly statement reflects services rendered through to the 25th of the month. All invoices are payable by the 8th of the following month (14 days).
Where applicable, invoices may be sent to your medical aid. You, however, acknowledge that if the account is not settled in full by the medical aid for whatsoever reason, you remain liable for the settlement of the full or outstanding balance of the account.
Accounts may be paid by cash electronic transfer (with surname or account number as the reference) to the therapist. If you wish to settle the account via a cash deposit, the cash deposit fee will be included on the account.
Should payment be outstanding for a period of 30 days, therapy will be discontinued until the account is settled.
Accounts that are not settled within 90 days are handed over for collection. You will be liable for any costs incurred by failure to settle the account including legal costs.
If, for whatever reason, your child will not be able to attend therapy for a given appointment, please notify the therapist the day before for morning appointments and by 7am for afternoon appointments; to allow alternative arrangements to be made.
Please note that sessions NOT timeously cancelled, as set out above, will be charged for in full unless such cancellation is due to an emergency.
Fees will increase annually in accordance with medical aid rate increases.
Invoices will be submitted to your medical aid (where applicable) and cc’d to your email address. Medical aid rates are charged.
If a claim is rejected by medical aid, you are liable for the payment of the account.
2021 Speech Therapy Rates
|821052||35- minute session||R380.00|
|821053||Speech therapy assessment 60 mins||R616.00|
|821051||Speech therapy assessment 30 mins||R264.00|
|821020||Speech therapy consultation 5-15 mins||R117.00|
|821021||Speech therapy consultation 16-30 mins||R264.00|
|821022||Speech therapy consultation 31-45 mins||R440.00|
|821023||Speech therapy consultation 46-60 mins||R616.00|
Home programs and reports:
|820009||Preparation of a home programme||R243.00|
I, the undersigned, accept full responsibility for my account and to settle any outstanding payments. Moreover, I accept full responsibility to ensure that I have received the necessary invoices for sessions that I have attended.
If my invoices are paid at private rates, I understand that it is my responsibility to make payment by the 8th of each month
If my invoices are being submitted to medical aid, I understand that it is my responsibility to liaise with my medical aid regarding payments due and keeping up-to-date with my available funds. The estimated time to get a payment from the medical aid is 4-6 weeks from the date that the invoice is submitted. With all rights reserved, Lauren Davission has the option to use legal methods to secure payment; this may include a collection agency or small claims court, in which case the cost of such measures will be added to the claim. Notices of outstanding accounts will be served to your residential, postal and work addresses.
I understand that Lauren Davission may suspend therapy until all outstanding accounts are settled in full.
I understand that if an appointment is not cancelled with 24 hour advance notice I will be charged to me in full. I accept that appointments are taken as confirmed at the time of verbal booking. Any reminders from Lauren Davission serve as a courtesy and have no bearing on the confirmation of an appointment.
I understand that that the email address and mobile number provided provided by me below will be used for all correspondence related to my appointments and invoices. Should I not receive the related invoice within 5 working days after a session (those that are attended or missed), I will be responsible for ensuring that I follow-up and ensure that I do have a copy of the related invoice.
I, the undersigned, accept that any late-coming will shorten the length of my session and I will be charged in full. Sessions cannot run overtime if the client is late.
While every effort is made to ensure your child’s safety, the practice and the therapist cannot be held liable for any loss, injury or accident that may occur during therapy which is attributable directly or indirectly to the therapist. You hereby indemnify and undertake to hold the practice and the therapist harmless against any injury, loss or damage that you or your child may suffer arising either directly or indirectly from therapy or any service provided in terms of this agreement.
Having read and understood these terms and conditions, by your signature, you hereby:
1 :: Agree and undertake to adhere to the terms and conditions as listed in the above contract;
2 :: Consent to the practice divulging information about your child in the case history form (verbally and in written form); and
3 :: Consent to your child to attending an assessment and/or sessions with Lauren Davisson. You acknowledge that during assessments and sessions your child may be subject to physical manipulation/contact i.e. touch – to assist with seating, positioning, oral-motor therapy etc. within the Children’s Act and you hereby consent to such physical manipulation / contact.
Note that the information below with a ‘*’ is mandatory. If you don’t have this information, you can enter a ‘-‘. However, if the information is missing or inaccurate, it will result in a delay of the appointment scheduling, billing process and/ or medical aid follow-up process.