Daniel P. Lyons, PMHNP-BC - This provider is a licensed Psychiatric & Mental Health Nurse Practitioner in the District of Columbia and is qualified to provide psychotherapy and psychopharmacological management services.

Appointments - Appointments can be made by calling (202) 505-8573 or by emailing Admin@Adaptivemindsdc.com. Keep in mind that email is not a secure method of communication. You are welcome to send texts for informal communication (i.e., running late to an appointment). ALL appointment requests, appointment cancellations, refill requests, notification of adverse events/side effects, or any other request for clinical consultation or action must be made through the patient portal (VALANT).

Active Clients - To be considered an “active member” of this practice, you must schedule a session with the provider at a minimum of every 3 months.

Appointment Cancelations, Rescheduling - If you would like to cancel or reschedule an appointment, please notify the provider via phone or email at least 24 hours in advance of your scheduled appointment or you will be charged for that appointment.

Fee structure: 

— $650/ 110-minute Initial Consultation Session

— $350/ 50-minute Full Session

— $250/ 25-minute Medication Check for established patients (approval required)

— $300/ 60-minutes Additional Consultation that occurs outside established appointments including consultation with external providers, conversations with parents, and documentation prep. Services will be billed in incremental units.

These fees and terms are subject to change upon sixty (60) days prior notice to you. If at any time you are unable or not willing to pay charges that your account has incurred, termination of services may occur.  

Insurance - This practice does not accept healthcare insurance and services will always be an “out-of-network” provider. Payment is expected at the time services are provided and the client is responsible for payment of all charges. 

Confidentiality - The practice will not release information or discuss your case unless it receives expressed consent or mandated or permitted by law. Possible exceptions to confidentiality include but are not limited to: child abuse; abuse of the elderly or disabled; sexual exploitation; AIDS/HIV and other communicable disease infection and possible transmission; court orders; criminal prosecutions; informing law enforcement of fraudulent methods to obtain medications or treatment; child custody cases; suits in which the mental health of a party is an issue; situations where the provider has a duty to disclose, or where, in the provider’s judgment, it is necessary to warn, protect, notify, or disclose; fee disputes between the client and provider; a negligence suit brought by you against the provider; the filing of a complaint with licensing board or other regulatory authority; to refute a defamatory review published by you or another on your behalf; to regulatory authorities in connection with their compliance or investigatory responsibilities; and to other licensed mental health professionals for treatment consultations when deemed necessary by the provider. 

Release of Information - By signing this consent form below, you are giving your consent to share confidential information with all persons mandated or permitted by law, with the behavioral health agency or provider that referred you to the practice, and with your primary care provider. You also provide consent for the provider to solicit information regarding your current medication regimen and/or prior medication history from other allied healthcare professionals (e.g., pharmacists), or the prescription history that may be available through electronic medical records or government databases, and all of your current and former healthcare providers. You also provide consent for the practice to contact law enforcement should the provider suspect fraudulent methods of obtaining medication or treatment. You are also releasing the provider and holding the provider harmless for any departure from your right of confidentiality that may result.

Audio and Video Recordings - By signing this consent form you understand and agree that sessions together or phone calls exchanged will not be recorded.  

Cooperation and Treatment Collaboration - You agree to keep the provider informed of any changes that may be made to your address, phone number, contact information, or business affiliation during the time period in which there is an active professional relationship. You agree to keep the provider informed of all changes to your medical history including medications prescribed, use of psychoactive and/or controlled substances, supplements, and treatment by other healthcare providers including allied health and complementary healthcare providers. 

Termination of Services - There may be a time that it may be determined a client is not appropriate for the services that are provided and therefore services may be terminated. Some, but not all, of the reasons services may be terminated include: a client’s failure to comply with treatment recommendations; a client who uses information to receive a type of treatment or medication; a client who uses verbal or physical aggression toward the provider or any other individual associated with the practice; using medications in a manner other than that prescribed; allowing others access to prescribed medication, or failure to pay fees in the time allotted on invoices. 

Defamation - By signing this information and consent form below you agree that you will not make defamatory comments about the provider to others or post defamatory commentary about the provider on any website or social media site. In the event that defamatory remarks about the provider are made by you or others acting in concert with you, you further consent to allow the provider to use confidential information necessary to rebut or defend against or prosecute claims for the defamation. 

Refill Prescriptions – “Active Clients” are eligible to receive refill prescriptions and should allow 3 business days for refill requests to be processed. 

Consent for Treatment – I consent for Daniel P. Lyons to assess and treat me, the client. This treatment may include psychotherapy, medication prescription, coaching, education, or other therapies for health conditions. I acknowledge that I have read, understood, and agreed to be bound by all the terms and conditions this form contains. Ample opportunity has been offered to the client to ask questions and seek clarification of anything unclear to the client. 

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Client Signature Date

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Client Name - Printed

For more information about client consent, we can help. Please visit: http://www.adaptivemindsdc.com/contact or email contact@adaptivemindsdc.com for more information or to connect.