Register

Registration is only required if you do not have a username. Please check your spam & junk mail folders to ensure you have not already received an email with a username and password. If you already have a username log in here

Each account must have a unique email address associated with it. Please contact us if you need multiple accounts with the same email address (i.e. related family members).

Therapist

Client Information

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Bill To Contact

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Log in Details

( If client is a minor, the legal guardian must enter their email address below. )



Between 8 and 40 letters and numbers

Challenge Questions

( These will be used to retrieve your password. Answers must be between 4 and 30 characters, cannot contain any spaces. )




( If you feel you must write down your questions in order to remember them, make sure to keep it in a safe place. )

Terms and Policy

Family Roots Cancellation Policy

No show/cancellation policy: 

Consistency is an important part of your or your child's therapy. We also hold appointment times for you and your family that we cannot offer to other families if an appointment is cancelled at the last minute. For no shows or cancellations made less than 24 hours in advance, a late cancel/no show fee of $50 will be charged to your card on file. We may choose to waive the fee at our discretion. Because we understand that sometimes people make mistakes or circumstances are beyond your control, our general guideline is to waive the fee for the first no show/cancellation and for unforeseen or emergency circumstances such as sudden illness and dangerous road conditions. Please note that if frequent cancellations and no shows are interfering with treatment, your therapist may need to terminate treatment or no longer guarantee a certain time slot in order to offer this time to another client. 

Medicaid clients (OHP CareOregon or Open Card) are exempt from the late cancel/no show fee, but your therapist may still terminate treatment in the case of recurring no shows or cancellations. 



( Type Full Name )
Insurance billing policy

Insurance Policy: 

By entering your insurance information, you are giving us permission to bill your insurance and to communicate the personal information with your insurance company necessary for billing purposes. Please note that we must provide a mental health diagnosis in order to bill insurance. Please discuss this with your or your child's therapist if you have concerns about this diagnosis. We believe that, while a diagnosis may be necessary, it is merely a description of symptoms and does not define you or your child.  

We will verify your insurance benefits prior to treatment as a courtesy to you. We do our best to provide accurate information about your insurance benefits, but please note that we can only provide an estimate of the cost of services. You are ultimately responsible for understanding your insurance benefits and you will be responsible for any fees not covered by insurance. If you are concerned about coverage, we encourage you to contact your insurance company directly to confirm coverage. 


You are also responsible for keeping your insurance information updated and notifying us of any changes in coverage. 


Please choose the "self pay" option if you are paying out of pocket for services. If you require a superbill to be reimbursed by your insurance company, please let us know by contacting info@familyrootstherapy or 503-746-3373 and we will provide instructions for how to download your superbills/receipts from the client portal. 

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Credit Card on File

Credit Card on file: 

We require that all clients save a credit card on file. You will be prompted to enter credit card information when filling out paperwork. Your credit card information is stored securely in our client portal. We cannot even see the credit card information once you enter it. 


By accepting this policy, you are consenting to charge any unpaid balances and cancellation fees as described in our policies to the card on file. 


Most clients prefer to have us bill the co-pay or session rate each week as a courtesy rather than log in to pay an invoice each week. If you prefer to pay each invoice on your own rather than be billed automatically, please let us know (info@familyrootstherapy.com) and we will not automatically bill your card each week. Please note that we do not allow clients to carry a balance (unless you have arranged for a payment plan) and your payment will be due each week at the time of session. Please note that if you choose not to be billed automatically, you may still be charged for overdue balances and cancellation fees. We will make attempts to reach out to you to arrange payment prior to making these charges. 


Due to current circumstances of offering virtual appointments only, we do not accept cash or checks as forms of payment at this time. 

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Electronic Communication Policy

Because we are mindful of our clients' privacy, Family Roots offers secure messaging through our client portal. If you wish to communicate electronically about your treatment or your child's treatment, the client portal is the most secure method. 

Your therapist may use e-mail to communicate about scheduling needs but will not send sensitive or personal information via unencrypted e-mail. You may choose to use unencrypted e-mail to communicate with your therapist if you prefer, as we recognize that some clients prefer e-mail communication. 


Please do not use text messages (SMS) to communicate with your therapist, as our phone system does not allow for texting on each therapists' individual extension. 


Family Roots uses Google Meet for Telehealth video sessions, which is a HIPAA secure video platform. You will receive links to join these sessions via e-mail. 


Therapists at Family Roots will not use any form of social media to communicate with clients and will not engage with clients on social media in any way, even if a client initiates contact. 


By signing below, I acknowledge that I have been informed of the risks of electronic communication and accept these risks should I choose to use unencrypted forms of communication. 

( Type Full Name )