TERMS AND CONDITIONS

REVIVE WELLNESS LLC

Effective Date: January 24, 2026

Last Updated: January 24, 2026

1. ACCEPTANCE OF TERMS

By accessing services, scheduling appointments, or engaging with REVIVE WELLNESS LLC ("Provider," "we," "us," or "our"), you ("Client," "you," or "your") agree to be bound by these Terms and Conditions. If you do not agree to these terms, you may not access or use our services.

2. SERVICES PROVIDED

REVIVE WELLNESS LLC is a multi-state behavioral health practice offering:

  • Individual, couples, and family therapy

  • DOT Substance Abuse Professional (SAP) evaluations and services

  • Court-ordered assessments and evaluations

  • Employee Assistance Program (EAP) services

  • Conflict mediation and resolution

  • Executive coaching and professional development

  • Educational programs and digital courses

  • Behavioral health compliance consulting

  • Early intervention programs

Services are provided in accordance with applicable federal and state laws in the District of Columbia, Maryland, Virginia, and Florida.

3. PROFESSIONAL RELATIONSHIP

3.1 Clinical Services

The relationship between Client and Provider is professional and therapeutic in nature. Services are provided by licensed mental health professionals under the clinical direction of Camille Lewis, LCPC-S, NCC, CEAP, DOT SAP.

3.2 Not Emergency Services

Our services are not appropriate for emergency situations. If you are experiencing a mental health emergency, call 988 (Suicide & Crisis Lifeline), 911, or go to your nearest emergency room.

3.3 Limitations

We do not provide:

  • 24/7 crisis intervention

  • Medication management or prescriptions

  • Legal advice or testimony (except as contractually agreed for court-ordered evaluations)

  • Guarantees of specific outcomes

4. CONFIDENTIALITY AND PRIVACY

4.1 HIPAA Compliance

We comply with the Health Insurance Portability and Accountability Act (HIPAA) and maintain strict confidentiality of your protected health information (PHI).

4.2 Limits to Confidentiality

Confidentiality may be limited or broken when:

  • You provide written authorization to release information

  • There is reasonable suspicion of child, elder, or dependent adult abuse

  • You present a serious danger to yourself or others

  • A court order is issued requiring disclosure

  • Required by law for DOT SAP reporting to employers/regulatory agencies

  • Necessary for treatment coordination with your consent

  • Required for billing and insurance purposes

4.3 DOT SAP Services

DOT SAP evaluations require reporting to employers and regulatory agencies as mandated by Department of Transportation regulations (49 CFR Part 40). By engaging DOT SAP services, you acknowledge and consent to required reporting.

5. FEES AND PAYMENT

5.1 Payment Responsibility

You are responsible for full payment of all fees incurred. Current fee schedules are available upon request and may vary by service type and jurisdiction.

5.2 Payment Methods

We accept cash, credit/debit cards, checks, and electronic payments. Payment is due at time of service unless prior arrangements have been made.

5.3 Insurance

If using insurance, you are responsible for:

  • Verifying coverage and benefits

  • Understanding your plan's limitations

  • Paying deductibles, co-pays, and co-insurance

  • Any charges not covered by insurance

We will bill your insurance as a courtesy, but you remain ultimately responsible for payment.

5.4 Court-Ordered and DOT SAP Services

These specialized services typically require payment in full at time of service and are generally not covered by insurance.

5.5 Late Payment

Accounts over 30 days past due may be subject to:

  • Late fees of $25 or 1.5% per month (whichever is greater)

  • Suspension of services until payment is received

  • Collection agency referral (you will be responsible for collection costs)

5.6 Sliding Scale

Limited sliding scale fees may be available based on financial need and provider availability. Inquire at intake.

6. APPOINTMENT POLICIES

6.1 Scheduling

Appointments must be scheduled in advance and are subject to provider availability.

6.2 Cancellation Policy

You must provide at least 24 hours advance notice to cancel or reschedule an appointment.

Late cancellations or no-shows (less than 24 hours notice) will be charged the full session fee unless due to emergency circumstances.

6.3 Late Arrivals

If you arrive more than 15 minutes late, your appointment may need to be rescheduled, and late cancellation fees may apply.

6.4 Provider Cancellations

If we must cancel your appointment, we will make every effort to reschedule at your earliest convenience, and no fees will be charged.

7. TELEHEALTH SERVICES

7.1 Availability

We offer secure telehealth services via HIPAA-compliant platforms for eligible clients in states where our providers are licensed.

7.2 Client Responsibilities

When using telehealth, you must:

  • Be physically located in a state where your provider is licensed

  • Use a private, secure location

  • Have reliable internet connection

  • Use a device with audio and video capabilities

  • Confirm your location at the beginning of each session

7.3 Technology Limitations

We are not responsible for technology failures. If a session is interrupted, we will attempt to reconnect. If unable to reconnect within 10 minutes, the session will be rescheduled.

8. DIGITAL PRODUCTS AND COURSES

8.1 License to Use

Digital courses and educational materials are licensed for your personal, non-commercial use only.

8.2 No Refunds

Digital products are non-refundable once accessed or downloaded.

8.3 Intellectual Property

All course content, materials, and resources are copyrighted and may not be reproduced, distributed, or shared without written permission.

9. CLIENT RESPONSIBILITIES

You agree to:

  • Provide accurate and complete information

  • Arrive on time for scheduled appointments

  • Give proper notice for cancellations

  • Pay fees when due

  • Participate actively and honestly in your treatment

  • Follow treatment recommendations

  • Notify us of any changes to contact information, insurance, or relevant circumstances

  • Respect professional boundaries

10. RECORD RETENTION

Clinical records are maintained in accordance with applicable state and federal laws, typically for a minimum of 7 years after the last date of service (or longer as required by specific regulations or circumstances).

11. TERMINATION OF SERVICES

11.1 Client-Initiated

You may terminate services at any time. We recommend a termination session to ensure proper closure and continuity of care.

11.2 Provider-Initiated

We reserve the right to terminate the professional relationship if:

  • You fail to pay for services

  • You repeatedly miss or late-cancel appointments

  • You engage in threatening or abusive behavior

  • We determine we cannot adequately meet your needs

  • Continuing services would violate ethical or legal standards

We will provide appropriate referrals and records transfer upon termination.

12. COMPLAINTS AND GRIEVANCES

If you have concerns about services, please contact our Clinical Director at info@revivewellnesscenter.org or 301.609.2675.

You also have the right to file a complaint with the appropriate licensing board:

  • DC: DC Board of Professional Counseling

  • Maryland: Maryland Board of Professional Counselors and Therapists

  • Virginia: Virginia Board of Counseling

  • Florida: Florida Board of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling

13. LIMITATION OF LIABILITY

To the fullest extent permitted by law, REVIVE WELLNESS LLC and its providers shall not be liable for any indirect, incidental, consequential, or punitive damages arising from services provided.

14. INFORMED CONSENT

By agreeing to these terms, you acknowledge that you have been informed about:

  • The nature and limitations of services

  • Provider qualifications

  • Fee structure and payment policies

  • Confidentiality and its limits

  • Your rights as a client

  • Risks and benefits of treatment

15. MODIFICATIONS

We reserve the right to modify these Terms and Conditions at any time. Changes will be posted on our website with an updated effective date. Continued use of services after changes constitutes acceptance of modified terms.

16. GOVERNING LAW

These Terms and Conditions shall be governed by the laws of the state in which services are provided.

17. CONTACT INFORMATION

REVIVE WELLNESS LLC
2255 Crain Highway, Suite 105
Waldorf, MD 20601
Phone: 301.609.2675
Email: info@revivewellnesscenter.org
Website: [Insert Website]

18. ACKNOWLEDGMENT

By signing below or clicking "I Agree" electronically, I acknowledge that I have read, understood, and agree to these Terms and Conditions.

Client Name (Print): ________________________________

Client Signature: ________________________________

Date: ________________________________

Provider Name: ________________________________

Provider Signature: ________________________________

Date: ________________________________

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