Terms of Services

Due to the nature of his international practices, Dr. Zibaie is not affiliated with any governmental agency, nonprofits, boards, or panels as he strictly work as a standalone provider. If there are indications that coaching is not enough and his clients are in need of higher levels of care, he will certainly aim to refer clients to receive higher level of care locally. He works with adults and families. His work with minors relies heavily on working with parents; therefore, if you wish for him to work with minors, it is mandated for the parents or legal caregivers to participate in receiving coaching regularly. As a member of a multicultural community, he feels confident providing services for individuals of all sexual orientations, races, cultures, and members of other minority groups. If you are receiving services in Farsi and have difficulties with English, please fill out the attached translated disclosure statement.

 

Fee and Pricing

FEE SCHEDULE:

Initial Evaluation--$175

Life-coaching sessions--$175

All other standard professional time will be billed at the standard hourly rate (prorated at $3.50/minute with

a 10 minute minimum charge). This includes phone calls, reports, letters, and third-party consultations. For

work outside the office, such as seeing patients in the hospital or house calls, the standard rate will be

calculated "door-to-door" -the entire time Dr. Zibaie is out of the office on your behalf

PAYMENT: Payment is due in full at the start of each session. Personal checks are accepted. All checks

should be made out to: Alireza Zibaie

 

Cancelation and no show Fee

OTHER CONSIDERATIONS: Late Cancellation Fee (less than 24 hours notice): $125 No show fees

(& Less than 3 hour cancellations notice): $175 Charge for checks returned or insufficient funds: $25.

APPOINTMENTS & CANCELLATIONS

At the end of the first session, once client and the therapist consider the therapeutic relationship to be the

right fit, arrangements for further sessions will be made. Due to Dr. Zibaie’s caseload, open times are

limited, but he will work with you as best he can. If you need to cancel a session, please do so as early as

possible. Late cancellations (less than 24 hours before) will be charged $125.

 

PHONE CALLS & MESSAGES

Standard: You may call/text anytime. If you do not reach Dr. Zibaie in person, you may leave a

confidential voice-mail message and he will promptly return calls, but delays may occur at times.

Emergencies: In private practice settings, patients are assumed to be self-responsible. It is important for

Dr. Zibaie’s self-care that after hours times only be interrupted for a true emergency (typically a lifethreatening

situation). Any expectations of after-hours care should be discussed upon intake so that, if

necessary, an appropriate referral can be made.

SLIDING SCALE AND CO-PAY

Sliding scale services are provided on income basis. In order to qualify for sliding scale, our accountant

will review client’s proof of income (pay stubs, tax returns, etc.,) - the monthly contracted sliding scale

value must be paid in full at the beginning of each month. The offset balance of the sliding scale system is

paid by a limited number of donation providers.

In an emergency, Dr. Zibaie can usually be reached on his satellite phone anywhere at 803-630-8181.

If you cannot reach him for any reason or would like to use an alternative support resource, you may

call: Helpline: 211 or 911