Journey Clinical Patient Terms and Conditions

Journey Clinical Terms and Conditions

YOU ACKNOWLEDGE THAT YOU HAVE READ, ACCEPTED, AND AGREE TO BE BOUND BY THESE TERMS AND CONDITIONS. IF YOU DO NOT AGREE TO THESE TERMS AND CONDITIONS, DO NOT USE THE SERVICES WE PROVIDE. 

Journey Clinical Inc. (“Journey,” “we,” or “us”) owns and operates the website located at www.journeyclinical.com, an online platform [and may operate a “Journey” mobile application] (collectively, the “Platform”). Your access and use of the Platform, any part thereof, or anything associated therewith, including its content (“Content”), any products or services provided through the Platform or otherwise by Journey, including assessing and selecting psychotherapists to participate in a health network, providing access to physicians and nurse practitioners (the “Providers”) employed or engaged by Journey Clinical Psychiatry, P.C., Inc., Journey Clinical Psychiatry CA, P.C., and Journey Clinical Psychiatry, TX, PLLC (collectively, the “Practices”), providing access to scheduling and educational features, and other services related to facilitating the provision of psychedelic therapies to qualified patients (collectively, including the Platform and the Content, the “Service”) are governed by these Terms and Conditions (“Terms and Conditions” or “Agreement”).

Please read this Agreement carefully because it sets forth the important terms you will need to know about the Service. In this Agreement, the terms “you” and “yours” refer to the person using the Service.

IF YOU HAVE A MEDICAL EMERGENCY, IMMEDIATELY CALL YOUR HEALTH CARE PROVIDER OR DIAL 911.

THE SERVICE IS NOT APPROPRIATE FOR ALL MEDICAL CONDITIONS OR CONCERNS.

THIS AGREEMENT IS SUBJECT TO CHANGE AS PROVIDED HEREIN.

Acceptance of Terms and Conditions

Your access to and use of the Service is subject to this Agreement, as well as all applicable laws and regulations. If you do not accept and agree to be bound by this Agreement in its entirety, you are strictly prohibited from visiting, accessing, registering with and/or using the Service or any information or Content provided through the Service, except as necessary to review this Agreement. The Service is continually under development, and we reserve the right to revise or remove any part of this Agreement or the Service at our sole discretion at any time and without prior notice to you. Any changes to this Agreement are effective upon posting to the Platform. Unless otherwise indicated, any new Content added to the Service is also subject to this Agreement upon posting to the Platform. If you disagree with this Agreement or any terms or conditions herein, your sole remedy is to discontinue your use of the Service. Your continued use after a change to this Agreement has been posted constitutes your acceptance of this Agreement as modified by such changes.

Your Relationship with Us

We are a management services organization that connects psychotherapists and patients qualified to use the Service (“Users”) with the services of the Providers to facilitate the provision of psychedelic therapies prescribed by the Providers. While we do not employ the Providers, our Service provides access to the Providers through the Platform. By accepting this Agreement, you acknowledge and agree that any services you receive from the Providers through the Platform are also subject to this Agreement, and that the Providers are third-party beneficiaries of this Agreement.

With respect to the Providers, we act solely to provide administrative services and as a technology platform to connect you with the services offered by the Providers through the Service. We do not control or interfere with the practice of medicine or the practice of any other professional services by the Providers, each of whom is solely responsible for professional services rendered to you or your patients. Journey makes no representations or warranties about the suitability, reliability, timeliness or accuracy of the medical care and treatment provided by any Providers. By accepting this Agreement, you acknowledge and agree that Journey is not a healthcare provider or provider of any other professional service, and that by using the Service, you are not entering into a doctor-patient, therapist-patient or other provider-patient relationship with Journey. By using the Service, you or your patients may, however, be entering into a doctor-patient or other health care provider-patient relationship with one or more of the Providers.

By accepting this Agreement, you acknowledge and agree that the Providers may send you messages, reports, and emails via the Service. You further understand and agree that it is your sole responsibility to monitor and respond to these messages, reports, and emails and that neither Journey nor any Provider will be responsible in any way and you will not hold Journey or any Provider liable for any loss, injury, or claims of any kind resulting from your failure to read or respond to these messages or, as applicable, for your failure to comply with any treatment recommendations or instructions from the Provider(s).

While you are not establishing a doctor-patient or other health care provider-patient relationship with Journey, by using the Service, you are establishing a direct customer relationship with Journey to use the Platform. In connection with such relationship, you may provide to us, or cause to be provided to us on your behalf, personal information, including health information, that is subject to use by us in accordance with our Privacy Policy.

Availability

Our Service is currently only available to individuals who are located in states in which we offer the Service, are at least eighteen (18) years of age or older, or at least the age of majority in their jurisdiction of residence, if higher than eighteen (18), and who have accepted this Agreement. By visiting, accessing, registering with or using the Service, you are (a) representing and warranting to us that you satisfy all of these eligibility requirements, (b) agreeing to comply with all applicable laws in visiting, accessing, registering with or using the Service, and (c) agreeing that you will only use the Service for lawful purposes. Our Service is subject to state and federal regulations and may change from time to time due to changes in applicable regulatory requirements.

The Service is structured for use specific to certain health care services and is not, and should not be considered or used as comprehensive medical advice or treatment.  In some cases, the Service may not be the most appropriate way for you to provide information to, communicate with or seek medical care and treatment from a provider. For example, certain medical conditions may require an in-person procedure with a healthcare provider other than a Provider, or the Provider may determine that your or your patient’s diagnosis and/or treatment requires an in-person office visit or are otherwise not appropriately addressed through use of the Service. In such a case, you or your patient may receive notification that you will be unable to use the Service for the particular issue submitted and the Provider may provide you with additional information regarding next steps.

Duty to Provide Information, Access, and Connectivity

You are responsible for providing and maintaining, at your own risk, option and expense, appropriate software and hardware capabilities (consistent with any technical, quality or other requirements described in the Service) to enable use of the Service, including but not limited to, a computer or mobile device with a video camera and Internet access. You are solely responsible for any fees, including Internet connection or mobile fees, that you incur when accessing the Service. You also have a duty to provide truthful, accurate and complete information in any forms or other communications you submit to or through the Service. You may be asked by us or a Provider to provide information for the purpose of provision of the Service to you.  You may elect to withhold requested information; however, if you do so, you may be precluded from using the Service.  We reserve the right to change the access configuration, including any software, hardware or other requirements of the Service at any time without prior notice.

Privacy Policy

Journey understands the importance of confidentiality and privacy regarding your personal information. Please see our Privacy Policy for a description of how we may collect, use and disclose your personal information.

Registration; User Accounts, Passwords, and Security

You may be obligated to register and set up an account in the Platform in order to access the Service, and the Service may be limited to Users who have registered and have been granted accounts with usernames and passwords. You agree to accurately maintain and update any information about yourself that you have provided to Journey or the Providers. If you do not keep such information current, or fail to submit truthful, accurate and complete information, or we have reasonable grounds to suspect as much, we have the right to suspend or terminate your account and your use of the Service. You also agree to immediately notify Journey of any unauthorized use of your username, password or any other breach of security that you become aware of involving or relating to the Service by emailing us at info@journey.clinic. In addition, you agree to keep confidential your username and password and to exit from your User account at the end of your use. Journey explicitly disclaims liability for any and all losses and damages arising from your failure to comply with this section. You may not use anyone else’s account at any time.

When establishing an account, you may be required to provide a username and password that will be used as your login for your account. To help protect the privacy of data you transmit through the Service, where personally identifiable information is requested, we also use technology designed to encrypt the information that you input before it is sent to us using Secure Sockets Layer (SSL) technology or similar encryption technology. In addition, we take steps to protect the User data we collect against unauthorized access. However, you should keep in mind that the Service and our services are run on software, hardware, and networks, any component of which may, from time to time, require maintenance or experience problems or breaches of security beyond our control. In addition, persons with access to your computer, phone, or other mobile or other devices may be able to access the Service and information about you contained in the Service. It is your responsibility to affirmatively logout from your account when you are not actively using it. It is also your responsibility to secure and prevent unauthorized physical access to your computer, phone and other devices, and to protect the confidentiality of your username and password.  You are responsible for promptly changing your password if you believe that it has been compromised.

You must exercise caution, good sense, and sound judgment in using the Service. You are prohibited from violating, or attempting to violate, the security of the Service. Any such violations may result in criminal and/or civil penalties against you. Journey may investigate any alleged or suspected violations and if a criminal violation is suspected, Journey may cooperate with law enforcement agencies in their investigations.

Use and Ownership of the Service

The Service and the information and Content available through the Service are protected by copyright laws throughout the world. Subject to this Agreement, Journey grants you a limited, non-transferable, revocable license to access and use the Service for your personal use. Unless otherwise specified by Journey in a separate license, your right to use any of the Service or the Content is subject to this Agreement and all rights in the Service and Content are reserved by Journey. You agree that Journey and its suppliers own all rights, title and interest in the Service (including but not limited to, any computer code, social media posts, themes, objects, concepts, photographs, product descriptions, blog posts, artwork, illustrations, animations, sounds, musical compositions, audiovisual effects, methods of operation, moral rights, and documentation). You will not remove, alter or obscure any copyright, trademark, service mark or other proprietary rights notices incorporated in or accompanying the Service. Journey’s stylized name and other related graphics, logos, service marks and trade names used on or in connection with the Service are the trademarks of Journey and may not be used without permission, including in connection with any third-party products or services. Other trademarks, service marks and trade names that may appear on or in the Service are the property of their respective owners.

License to Information Submitted via the Service

Subject to any legal limitations, any information you transmit to Journey via the Service, whether by direct entry, submission, email or otherwise, including data, questions, comments, or suggestions (collectively, “Submissions”), will, to the extent permitted under applicable law, be treated as non-confidential and non-proprietary. Subject to any applicable account settings that you select, you grant Journey a fully paid, royalty-free, perpetual, irrevocable, worldwide, non-exclusive and fully sublicensable right (including any moral rights) and license to use, license, distribute, reproduce, modify, adapt, publicly perform, and publicly display, Submissions (in whole or in part) for the purposes of operating and providing the Service to you and to our other users. You warrant that the holder of any worldwide intellectual property right, including moral rights, in Submissions has completely and effectively waived all such rights and validly and irrevocably granted to you the right to grant the license stated above. You agree that you, not Journey, are responsible for all of Submissions that you provide to the Service. In addition to the foregoing, Journey shall have the right, in its sole discretion, to edit, duplicate, or alter the Submission in any manner for any purpose that Journey deems necessary or desirable, and you irrevocably waive any and all so-called moral rights you may have in the Submission. You further agree that you shall have no right of approval and no claim to compensation in connection with the Submission.

If a Submission you make contains Personal Information, as defined in our Privacy Policy, Journey’s rights under this section with respect to the use or disclosure of such Personal Information will be limited as and to the extent required under applicable law.

Prohibited Use

Any use or attempted use of the Service (i) for any unlawful, unauthorized, fraudulent or malicious purpose, (ii) that could damage, disable, overburden, or impair any server, or the network(s) connected to any server, (iii) that could interfere with any other party’s use and enjoyment of the Service, (iv) to gain unauthorized access to any other accounts, computer systems, or networks connected to any server or systems through hacking, password mining or any other means, (v) to access systems, data, or information not intended by Journey to be made accessible to a user, (vi) to obtain any materials, or information through any means not intentionally made available by Journey, (vii) to reverse engineer, disassemble or decompile any section or technology on the Service, or (viii) for any use other than the business purpose for which it was intended, is prohibited.

In addition, in connection with your use of the Service, you agree you will not:

• upload or transmit any message, information, data, text, software or images, or other content that is unlawful, harmful, threatening, abusive, harassing, tortious, defamatory, vulgar, obscene, libelous, or inappropriate with respect to race, gender, sexuality, ethnicity, or other intrinsic characteristic, or that may invade another’s right of privacy or publicity;
• create a false identity or duplicative accounts for the purpose of misleading others or impersonate any person or entity, including, without limitation, any Journey representative, or falsely state or otherwise misrepresent your affiliation with a person or entity;
• upload or transmit any material that you do not have a right to reproduce, display or transmit under any law or under contractual or fiduciary relationships (such as nondisclosure agreements);
• upload files that contain viruses, trojan horses, worms, time bombs, cancel-bots, corrupted files, spyware or any other similar software or programs that may damage the operation of another’s computer or property of another;
• delete any author attributions, legal notices or proprietary designations or labels that you upload to any communication feature;
• attempt to restrict any person from using or enjoying the Service, nor encourage or facilitate violations of these Terms and Conditions or any other Journey terms;
• violate any applicable local, state, national or international law;
• upload or transmit any material that infringes any patent, trademark, service mark, trade secret, copyright or other proprietary rights of any party;
• delete or revise any material posted by any other person or entity;
• manipulate or otherwise display the Service by using framing, mirroring or similar navigational technology;
• probe, scan, test the vulnerability of or breach the authentication measures of, the Service or any related networks or systems;
• register, subscribe, attempt to register, attempt to subscribe, unsubscribe, or attempt to unsubscribe, any party for any services if you are not expressly authorized by such party to do so;
• harvest or otherwise collect information about others, including email addresses;
• use any robot, spider, scraper, or other automated or manual means to access the Service, or copy, download, distribute or reproduce any content or information on the Service; or
• assist or permit any person in engaging in any of these activities.

Journey reserves the right to take whatever lawful actions it may deem appropriate in response to actual or suspected violations of the foregoing, including, without limitation, the suspension or termination of a User's access and/or account. Journey may cooperate with legal authorities and/or third parties in the investigation of any suspected or alleged crime or civil wrong.

Except as may be provided in the Privacy Policy or prohibited by applicable law, Journey reserves the right at all times to disclose any information as Journey deems necessary to satisfy any applicable law, regulation, legal process or governmental request.

Right to Monitor

Journey reserves the right to monitor general use of the Service at any time as it deems appropriate and to remove any materials that, in Journey’s sole discretion, may be illegal, may subject Journey to liability, may violate this Agreement, or are, in the sole discretion of Journey, inconsistent with Journey’s purpose for the Service.

Third-Party Goods and Services

Parties other than Journey, including Providers (collectively, “Third Parties”) provide services or sell products through the Service, and Journey may also make available to you for purchase certain services, devices, items or products manufactured, distributed or sold by Third Parties (collectively, “Third-Party Goods and Services”). Your use of any Third-Party Goods and Services and any interactions with Third Parties, including payment and delivery of goods or services, and any other terms, conditions, warranties or representations associated with such use or interactions, are solely between you and such Third Parties. You should make whatever investigation you feel necessary or appropriate before proceeding with any online or offline transaction involving Third Parties or any Third Party Goods and Services. You are solely responsible for, and shall exercise caution, discretion, common sense and judgment in, using the Service and disclosing Personal Information.

You agree that Journey shall not be responsible or liable for any loss or damage of any sort incurred as the result of your use of the Platform, any Third-Party Goods and Services or your interactions with any Third Parties. In the event of any dispute between you and any Third Party, any other User or any other entity or individual, you understand and agree that Journey is under no obligation to become involved in such dispute, and you hereby release and indemnify Journey, its affiliates and all of their respective contractors, directors, officers, employees, representatives, proprietors, partners, shareholders, servants, principals, agents, predecessors, successors, assigns, accountants, and attorneys (collectively, “Journey Parties”) from any and all claims, demands and/or damages (actual or consequential) of every kind or nature, known or unknown, suspected and unsuspected, disclosed or undisclosed, arising out of or in any way related to such disputes or the Service or the features and services therein. IF YOU ARE A CALIFORNIA RESIDENT, YOU WAIVE CALIFORNIA CIVIL CODE SECTION 1542, WHICH STATES: “A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS THAT THE CREDITOR OR RELEASING PARTY DOES NOT KNOW OR SUSPECT TO EXIST IN HIS OR HER FAVOR AT THE TIME OF EXECUTING THE RELEASE AND THAT, IF KNOWN BY HIM OR HER, WOULD HAVE MATERIALLY AFFECTED HIS OR HER SETTLEMENT WITH THE DEBTOR OR RELEASED PARTY."

Certain of Journey’s shareholders, directors, officers, employees, contractors or agents (collectively, “Journey Owners and Personnel”) may have a financial interest in one or more Third Parties, and may profit from your use of the Third Parties and/or the sale of Third-Party Goods and Services to you.

Terms and Conditions of Payment; Terms of Sale

Receipt of health care services from a Provider, including but not limited to the Practices, and your use of the Platform in connection with such health care services, constitutes an ongoing agreement to these terms and conditions of payment. For health care services connected to a Provider engaged by the Practices, your payment will be governed by the Financial Responsibility form that you will be required to consent to. Further, the Practices accept certain commercial insurance plans. Please contact your insurance plan to confirm whether the Practice(s) is in network with your plan, and any cost-sharing or co-payment obligations that you may have.

You understand that Journey does not provide health care services; however, Journey may collect and remit all payments from you for the services rendered by Providers, and you authorize Journey to remit payment information to such Provider as outlined in the Financial Responsibility form. 

We may offer reductions or discounts or other promotions for our services (“Discounts”). The terms and expirations of any Discounts shall be those specified with the particular discount or promotion. You may take advantage of any such Discounts through the ‘Discount’ field during checkout. Your use of any such Discount shall not form part of any contract between us. Discounts have no cash redemption value. We reserve the right to vary or discontinue the Discounts at any time and without prior notice.

You are responsible for any applicable sales, use, duty, customs or other governmental taxes, levies or fees (“Taxes”) due with respect to your purchase of products or services through our Service. We will collect applicable Taxes if we determine we have a duty to collect Taxes. We will present an estimate of Taxes we collect at checkout, except where we have clearly stated in writing that a price includes Taxes. The actual Taxes charged may be adjusted from the amount shown at checkout. Several factors may cause this, such as variances between processor programs and changes in tax rates. We are not required to, and do not, collect Taxes in all states. You may have a duty to directly report and pay Taxes if we do not collect such Taxes.

Only valid payment methods acceptable to us may be used to complete a purchase via the Service. You represent and warrant that you are authorized to use your designated payment method. You authorize us to charge your designated payment method for the total amount of your order (including any applicable taxes and shipping and handling charges). If any of the products in your order are unavailable, we will only charge the prices, Taxes and other applicable charges associated with the products that are included in the shipment. In connection with any purchase you make through the service, you may be asked to supply certain information relevant to the transaction, including, without limitation, your credit card number and expiration date, your billing address, your shipping address, your phone number and/or your email address. By submitting such information, you grant Journey without charge the irrevocable, unencumbered, universe-wide and perpetual right to provide such information to third parties (e.g., payment processing companies, buyers on the Service, sellers on the Service) for the purpose of facilitating the transaction.

All credit card, debit card and other monetary transactions on or through the Service occur through an online payment processing application(s) accessible through the Service. This online payment processing application(s) is provided by Journey’s third-party online payment processing vendor. The payment processing vendor is nothing more than a third-party vendor to Journey, and is in no way subject to Journey’s direction or control; thus, their relationship is not, and should not be construed as, one of fiduciaries, franchisors-franchisees, agents-principals, employers-employees, partners, joint venturers or the like.

You agree to pay any shipping and handling charges, if any, shown at the time you make a purchase. We reserve the right to increase, decrease, add or eliminate shipping and handling charges from time to time, but we will provide notice of the changes applicable to you before you make your purchase. Any delivery dates or times shown as part of the checkout process are estimates only and are not guaranteed. Unless we state otherwise in writing via the Service, risk of loss or damage to a product passes to you upon delivery of the product to our designated carrier.

We reserve the right to remedy User issues and concerns on a case by case basis. We reserve the right, in our sole discretion, to resolve customer issues and concerns based on the facts and circumstances of each User.

Termination

Journey may terminate your use of the Service or any of our features or services at any time and for any reason without notice, including, for example, for conduct violating this Agreement or if we discontinue the Service. The provisions of this Agreement concerning Service security, prohibited activities, copyrights, trademarks, user submissions, disclaimers, limitation of liability, arbitration and resolution of Disputes, indemnity and jurisdictional issues shall survive any such termination or any other termination of this Agreement or your relationship with Journey. You agree that if your use of the Service is terminated pursuant to this Agreement, you will not attempt to use the Service under any name, real or assumed, and further agree that if you violate this restriction after being terminated, you will indemnify and hold all Journey Parties harmless from any and all liability that any such Journey Parties may incur with respect thereto.

Except as otherwise provided in the Privacy Policy or as required by applicable law, we have no obligation, whether before or after the termination of your use of the Service, to return or otherwise provide to you or any third party on your behalf any Content, any information you provide to us, any information your Providers provided to us about or relating to you, or any other information that we may have that relates to you.

Disclaimers

Content and other information contained on the Service is provided by Journey as a convenience. Users relying on Content or other information from the Service do so at their own risk.

THE SERVICE IS PROVIDED ON AN “AS IS” OR “AS AVAILABLE” BASIS. ANY ACCESS TO OR USE OF THE SERVICE IS VOLUNTARY AND AT THE SOLE RISK OF THE USER. THE JOURNEY PARTIES AND EACH THIRD PARTY OFFERING PRODUCTS OR SERVICES THROUGH THE SERVICE, INCLUDING THE PROVIDERS, TO THE FULLEST EXTENT PERMITTED BY LAW, DISCLAIMS ALL WARRANTIES AND CONDITIONS OF ANY KIND, EITHER EXPRESS OR IMPLIED, STATUTORY OR OTHERWISE, INCLUDING, WITHOUT LIMITATION, THE IMPLIED WARRANTIES OF MERCHANTABILITY, NON-INFRINGEMENT OF THIRD PARTIES’ RIGHTS, SATISFACTORY QUALITY AND FITNESS FOR PARTICULAR PURPOSE WITH REGARD TO THE SERVICE, AND WITH RESPECT TO ANY INFORMATION, CONTENT, PRODUCT, SERVICE, MERCHANDISE OR OTHER MATERIAL PROVIDED ON OR THROUGH THE SERVICE OR THE PLATFORM. JOURNEY DOES NOT WARRANT OR GUARANTEE THE ACCURACY, COMPLETENESS, RELIABILITY, TIMELINESS OR USEFULNESS OF THE SERVICE. JOURNEY DOES NOT WARRANT THAT THE SERVICE WILL FUNCTION WITHOUT DELAYS, DISRUPTIONS, INTERFERENCES, IMPERFECTIONS, CORRUPTION, CYBER ATTACK, VIRUSES, MALWARE, OR ANY ADVERSE INCIDENT.

BY ACCESSING OR USING THE SERVICE, YOU REPRESENT AND WARRANT THAT YOUR ACTIVITIES ARE LAWFUL IN EVERY JURISDICTION WHERE YOU ACCESS OR USE THE SERVICE.

Limitation of Liability

TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, IN NO EVENT SHALL THE JOURNEY PARTIES OR ANY THIRD PARTY OFFERING PRODUCTS OR SERVICES THROUGH THE SERVICE, INCLUDING THE PROVIDERS, BE LIABLE TO YOU OR ANY OTHER PERSON OR ENTITY FOR ANY INCIDENTAL, INDIRECT, SPECIAL, EXEMPLARY AND CONSEQUENTIAL DAMAGES, PERSONAL OR BODILY INJURY, EMOTIONAL DISTRESS, OR WRONGFUL DEATH, LOSS OF DATA, LOST PROFITS, OR DAMAGES RESULTING FROM THE USE OF OR INABILITY TO USE THE SERVICE, INCLUDING ANY INFORMATION AND CONTENT MADE AVAILABLE THROUGH THE SERVICE OR ANY SERVICES PERFORMED BY THE PROVIDER(S), WHETHER BASED ON WARRANTY, CONTRACT, TORT (INCLUDING NEGLIGENCE), OR ANY OTHER LEGAL THEORY, AND WHETHER OR NOT JOURNEY HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. THE JOURNEY PARTIES SHALL BE LIABLE ONLY TO THE EXTENT OF ACTUAL DAMAGES INCURRED BY YOU, NOT TO EXCEED U.S. $1,000.

ANY CLAIMS ARISING IN CONNECTION WITH YOUR USE OF THE PLATFORM, SERVICE OR CONTENT MUST BE BROUGHT WITHIN ONE (1) YEAR OF THE DATE OF THE EVENT GIVING RISE TO SUCH ACTION OCCURRED. YOU UNDERSTAND AND AGREE THAT YOUR USE OF THE PLATFORM, SERVICE OR CONTENT IS PREDICATED UPON YOUR WAIVER OF ANY RIGHT TO PARTICIPATE IN A CLASS ACTION SUIT FOR ANY LOSSES OR DAMAGES RESULTING FROM YOUR USE OF THE PLATFORM, SERVICE OR CONTENT.

SOME JURISDICTIONS DO NOT ALLOW THE EXCLUSION OF CERTAIN WARRANTIES OR THE LIMITATION OR EXCLUSION OF LIABILITY FOR INCIDENTAL OR CONSEQUENTIAL DAMAGES. TO THE EXTENT THAT WE MAY NOT DISCLAIM ANY IMPLIED WARRANTY OR LIMIT ITS LIABILITIES, THE SCOPE AND DURATION OF SUCH WARRANTY AND THE EXTENT OF OUR LIABILITY WILL BE THE MINIMUM PERMITTED UNDER APPLICABLE LAW.

Indemnification

You agree to defend, indemnify, and hold the Journey Parties and any Third Party offering products or services through the Service, including the Providers, harmless from and against any and all suits, actions, claims, proceedings, damages, settlements, judgments, injuries, liabilities, obligations, losses, risks, costs, and expenses (including, without limitation, attorneys’ fees and litigation expenses) relating to or arising from your use of the Service, your fraud, violation of law, or willful misconduct, any breach by you of these Terms and Conditions or your violation of any rights of any other person or entity. We reserve the right to control the defense of any claim by a third party for which we are entitled to indemnification, and you agree to provide us with such cooperation as is reasonably requested by us.

Notices

Any notices to you from Journey regarding the Service or this Agreement may be made by email, a posted notice on the Service, or regular mail, in the sole discretion of Journey.

Electronic Communications

When you access or use the Service or send emails to us or the Providers, you are communicating with us and the Providers electronically. You consent to receive communications from us and the Providers electronically. We will communicate with you via email or through the Service. You agree that all agreements, notices, disclosures and other communications that we provide to you electronically satisfy any legal requirement that such communications be in writing. You further agree that any notices provided by us electronically are deemed to be given and received on the date we transmit any such electronic communication as described in these Terms and Conditions.

Entire Agreement

This Agreement and any other agreements Journey may post on the Service or that you and Journey may execute from to time constitute the entire agreement between Journey and you in connection with your use of the Service and supersede any prior agreements between Journey and you regarding use of the Service, including prior versions of this Agreement.

Binding Arbitration / Class Waiver

YOU EXPRESSLY AGREE THAT ANY LEGAL CLAIM, DISPUTE OR OTHER CONTROVERSY BETWEEN YOU AND JOURNEY OR YOU AND ANY OF THE JOURNEY PARTIES OR ANY PROVIDER ARISING OUT OF OR OTHERWISE RELATING IN ANY WAY TO JOURNEY, THE PLATFORM, THE CONTENT OR THE SERVICE, OR ANY OTHER JOURNEY GOODS, SERVICES OR ADVERTISING, INCLUDING CONTROVERSIES RELATING TO THE APPLICABILITY, ENFORCEABILITY OR VALIDITY OF ANY PROVISION OF THIS AGREEMENT (COLLECTIVELY “DISPUTES”), SHALL BE RESOLVED IN CONFIDENTIAL BINDING ARBITRATION CONDUCTED BEFORE ONE COMMERCIAL ARBITRATOR FROM THE AMERICAN ARBITRATION ASSOCIATION (“AAA”), RATHER THAN IN A COURT, AS DESCRIBED HEREIN. THE ARBITRATION WILL BE GOVERNED BY THE AAA'S COMMERCIAL ARBITRATION RULES AND, IF THE ARBITRATOR DEEMS THEM APPLICABLE, THE SUPPLEMENTARY PROCEDURES FOR CONSUMER RELATED DISPUTES (COLLECTIVELY “RULES AND PROCEDURES”). YOU ACKNOWLEDGE THAT YOU ARE VOLUNTARILY AND KNOWINGLY FORFEITING YOUR RIGHT TO A TRIAL BY JURY AND TO OTHERWISE PROCEED IN A LAWSUIT IN STATE OR FEDERAL COURT, EXCEPT AS EXPRESSLY PROVIDED HEREIN.

Arbitration is more informal than a lawsuit in court. Arbitration uses a neutral arbitrator instead of a judge or jury, and court review of an arbitration award is very limited. However, an arbitrator can award the same damages and relief on an individual basis that a court can award to an individual.

Payment of arbitration costs will be governed by the AAA’s fee schedule, unless you are able to show that your portion will be prohibitive as compared to litigation costs, in which case Journey will pay as much of your arbitration costs as the arbitrator deems necessary to prevent the arbitration from being cost-prohibitive as compared to litigation costs. Journey also reserves the right in its sole and exclusive discretion to assume responsibility for all arbitration costs imposed by the AAA. Each party agrees to pay its own attorneys’ fees and expenses unless there is a governing statutory provision that requires the prevailing party to be paid attorneys’ fees and expenses.

The arbitration shall be conducted in New York, NY, except that, in the event New York, NY is not within 100 miles of your residence, the arbitration may be conducted within 100 miles of your residence, unless the parties agree otherwise in writing. The arbitrator’s award shall be final and binding on all parties and may be entered as a judgment in any court of competent jurisdiction.

For more information on AAA, its Rules and Procedures, and how to file an arbitration claim, you may call AAA at 800-778-7879 or visit the AAA website at www.adr.org.

Notwithstanding anything to the contrary herein, to the extent the Dispute arises from: (a) a violation of either party’s intellectual property rights in any manner; (b) any claim related to, or arising from, allegations of theft, piracy, unauthorized use or a violation of the Computer Fraud and Abuse Act; and/or (c) any claim for equitable relief; then you and Journey agree that a party may seek injunctive remedies (or an equivalent type of urgent legal relief) in a state or federal court in New York, NY, and both parties agree to submit to the personal jurisdiction of such courts in connection with such proceedings. In addition to the foregoing, either party may assert an individual action in small claims court for Disputes that are within the scope of such court’s jurisdiction in lieu of arbitration as long as such action remains in such court and advances only on an individual (non-class, non-representative) basis.

ALL DISPUTES SUBJECT TO ARBITRATION UNDER THIS AGREEMENT MUST BE ARBITRATED ON AN INDIVIDUAL BASIS AND NOT ON A CLASS, COLLECTIVE OR REPRESENTATIVE BASIS. NO PARTY MAY BRING ANY CLAIM SUBJECT TO ARBITRATION PURSUANT TO THIS AGREEMENT AS A PRIVATE ATTORNEY GENERAL, IN A REPRESENTATIVE CAPACITY, OR AS A PLAINTIFF OR CLASS MEMBER IN ANY PURPORTED CLASS PROCEEDING. THE CLAIMS OF MORE THAN ONE CUSTOMER OR USER CANNOT BE JOINED OR CONSOLIDATED WITH THOSE OF ANY OTHER CUSTOMER OR USER. NO ARBITRATION SHALL BE CONSOLIDATED OR JOINED WITH ANY OTHER ARBITRATION. THE ARBITRATOR MAY AWARD RELIEF (INCLUDING MONETARY, INJUNCTIVE, AND DECLARATORY RELIEF) ONLY IN FAVOR OF THE INDIVIDUAL PARTY SEEKING RELIEF AND ONLY TO THE EXTENT NECESSARY TO PROVIDE RELIEF NECESSITATED BY THAT PARTY’S INDIVIDUAL CLAIM(S). If a decision is issued stating that applicable law precludes enforcement of any of this paragraph’s limitations as to a particular claim or request for relief, then such claim or request for relief (and only that claim or request for relief) shall be severed from the arbitration and may be brought exclusively in the state or federal courts located in New York, NY, subject to the parties’ respective rights to appeal the decision. All other claims or requests for relief shall be arbitrated. The parties agree that any claims or requests for relief that are severed from an arbitration may not proceed in litigation and shall be stayed until all claims between the parties remaining in arbitration are finally resolved. The parties agree to submit to the personal jurisdiction of the federal and state courts located in New York, NY for purposes of resolving any claims or requests for relief severed from arbitration pursuant to this paragraph.

You can opt out of the provisions of this Agreement that require the arbitration of Disputes within 30 days of the date that you first agree to any version of this Agreement that requires arbitration of disputes with Journey. To opt out, you must send your name, residence address, and email address together with a clear statement that you want to opt out of the requirement to arbitrate disputes with Journey to: 80 5th Ave, floor 18, New York, NY, 10011.

Before you commence arbitration of a Dispute, you must provide us with a written Notice of Dispute that includes your name, residence address, username (if applicable) and email address associated with your User account (if applicable), a detailed description of the Dispute, and the relief you seek. Before we commence arbitration of a Dispute against you, we will provide a written Notice of Dispute to you with a detailed description of the Dispute and the relief we seek. Any Notice of Dispute you send to us should be mailed to 80 5th Ave, floor 18, New York, NY, 10011. If we are unable to resolve a Dispute within 30 days after the applicable Notice of Dispute is received, either party may commence arbitration. Notwithstanding anything to the contrary in this Agreement, if we make any future material modification to any provisions of this Agreement that govern the arbitration or resolution of Disputes, such changes will not apply to any Dispute between you and us for which either party had previously provided a written Notice of Dispute to the other in accordance with this paragraph. Further, if we make any future material changes to the provisions of this Agreement that govern the arbitration or resolution of Disputes, you may reject such changes by sending a written notice of your rejection decision to us at 80 5th Ave, floor 18, New York, NY, 10011 within 30 days of the effective date of such modifications.

Governing Law; Venue; Severability of Provisions

This Service is controlled and operated by Journey from our offices within New York, NY. Those who choose to access the Service from other locations do so on their own initiative and are responsible for compliance with local laws, if and to the extent applicable. Access to the Service from jurisdictions where the contents of the Service are illegal or penalized is prohibited.

The validity, interpretation, construction and performance of this Agreement will be governed by the Federal Arbitration Act and the laws of the State of New York, without regard to any conflicts of law provisions.

All parts of this Agreement apply to the maximum extent permitted by law. Our failure to enforce any provision of this Agreement will not constitute a waiver of such right. We both agree that if we cannot enforce a part of this Agreement as written, then that part will be replaced with terms that most closely match the intent of the unenforceable part to the extent permitted by law. Except as otherwise provided in this Agreement, the invalidity of part of this Agreement will not affect the validity and enforceability of the remaining provisions. The section headings are for convenience and do not have any force or effect.

No Agency Relationship

Neither this Agreement, nor any Content, materials or features of the Service create any partnership, joint venture, employment, or other agency relationship between you and Journey or the Providers. You may not enter into any contract on our behalf or bind us in any way.

Assignment

You may not assign any of your rights under this Agreement, and any such attempt will be null and void. Journey may, in its sole discretion, transfer, without further consent or notification, all contractual rights and obligations pursuant to this Agreement to any affiliate of Journey or to another third party in the event that some or all of the business of Journey is transferred to such other third party by way of merger, sale of its assets or otherwise.

Third Party Beneficiaries

Any use of third party software provided in connection with the Service, or any third party product or service accessed or used in connection with the Service, will be governed by the applicable third party’s license or terms of use, and not by this Agreement. In addition to this Agreement, your use of the Service must comply with all applicable third party terms of agreement.

Except for the foregoing or as otherwise specifically set forth in this Agreement, including with respect to the indemnification obligations contained herein in favor of the Journey Parties and the Providers and the agreement to arbitration, we hereby expressly agree that there is no intent by either party to create or establish third party beneficiary status rights or their equivalent in any other referenced individual, subcontractor or third party, including the Providers, and, except as specifically set forth in this Agreement, that no third party shall have any right to enforce any right or enjoy any benefit that is created or established under this Agreement.

Contacting Us

If you have any questions or concerns about this Agreement, please contact us by email at info@journey.clinic. We will attempt to respond to your questions or concerns promptly after we receive them.

Last Updated: June 24, 2024

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Privacy Policy

We at Journey Clinical Inc. (“Journey”) know you care about how your personal information is used and shared, and we take your privacy seriously. Please read the following to learn more about our Privacy Policy. By using or accessing our website, platform or other services (“Services”) in any manner, you acknowledge that you accept the practices and policies outlined in this Privacy Policy, and you hereby consent that we will collect, use, and share your information in the following ways.  If you do not agree with the terms of this Privacy Policy, please refrain from using or accessing the Services.‍

What does this Privacy Policy Cover?

This Privacy Policy covers our treatment of personally identifiable information (“Personal Information”) that we gather when you are accessing or using our Services, but not to the practices of companies we don’t own or control, or people that we don’t manage. We gather various types of Personal Information from our users, as explained in more detail below, and we use this Personal Information internally in connection with our Services, including to personalize, provide, and improve our services, to contact you and allow other users to contact you, to fulfill your requests for certain products and services, and to analyze how you use the Services. In certain cases, we may also share some Personal Information with third parties, but only as described below.

We do not knowingly collect or solicit personal information from anyone under the age of 13. If you are under 13, please do not attempt to register for the Services or send any personal information about yourself to us. If we learn that we have collected personal information from a child under age 13, we will delete that information as quickly as possible. If you believe that a child under 13 may have provided us personal information, please contact us at info@journey.clinic.

We do not control and are not responsible for the privacy practices of third parties, including those linked on our website or platform.  We encourage you to review the privacy policies of each website and application that you visit and use.

Will Journey ever change this Privacy Policy?

We’re constantly trying to improve our Services, so we may need to change this Privacy Policy from time to time as well, but we will alert you to changes by placing a notice on www.journeyclinical.com, by sending you an email, and/or by some other means. Please note that if you’ve opted not to receive legal notice emails from us (or you haven’t provided us with your email address), those legal notices will still govern your use of the Services, and you are still responsible for reading and understanding them. If you use the Services after any changes to the Privacy Policy have been posted, that means you agree to all of the changes.

What information does Journey collect and how is it used?

We receive and store any information you knowingly provide to us. For example, if you submit a form through the “Contact” page, we will collect Personal Information such as your name, organization name, age, state, phone number and email address. Certain information may be required to register with us, to participate in our network, to schedule services or to take advantage of some of our features. We may communicate with you if you’ve provided us the means to do so. For example, if you’ve given us your email address, we may send you promotional email offers on behalf of Journey or other businesses, or email you about your use of the Services. Also, we may receive a confirmation when you open an email from us. This confirmation helps us make our communications with you more interesting and improve our services. If you do not want to receive communications from us, please indicate your preference by sending an email to info@journey.clinic.

We also use your information to provide Services to you, to conduct outreach regarding expansion of our network, to provide you with customer support, to develop, test and improve our Services, to identify and create new services and to improve user experiences.‍

Will Journey share any of the Personal Information it receives?

We may choose to buy or sell assets, and may share and/or transfer account, contact, and other Personal Information in connection with the evaluation of and entry into such transactions. Also, if we (or our assets) are acquired, or if we go out of business, enter bankruptcy, or go through some other change of control, Personal Information could be one of the assets transferred to or acquired by a third party.

With respect to our psychotherapist members, we will share the contact information that you provide to us to other users so that they can identify you and your practice as part of our network.

We may de-identify your Personal Information so that you are not identified as an individual, and provide that information to our partners. We may also provide aggregate usage information to our partners (or allow partners to collect that information from you), who may use such information to understand how often and in what ways people use our Services, so that they, too, can provide you with an optimal online experience.

In some circumstances, we employ other companies and people to perform tasks on our behalf and need to share your information with them to provide products or services to you; for example, we may use a third-party mail management service to send you emails on our behalf. Unless we tell you differently, our agents do not have any right to use the Personal Information we share with them beyond what is necessary to assist us.

We reserve the right to access, read, preserve, and disclose any information that we reasonably believe is necessary to comply with law or court order; enforce or apply this Privacy Policy and other agreements; or protect the rights, property, or safety of Journey, our employees, our users, or others.

Is Personal Information about me secure?

We endeavor to protect the privacy of your Personal Information we hold in our records. While we take strict measures to protect information, we cannot guarantee complete security, such as from unauthorized entry or use, hardware or software failure, and other factors that may compromise the security of user information.‍

Does Journey offer medical advice?

Journey, as a health care platform and clinical support entity, does not offer medical advice or diagnoses, or engage in the practice of medicine. Our Services are not intended to be a substitute for professional medical advice, diagnosis, or treatment and are offered for informational and communicative purposes only. The Services are not intended to be, and must not be taken to be, the practice of medicine, nursing, pharmacy or other healthcare advice by Journey.

The Services are not meant to diagnose or treat any conditions – only your medical professional can determine the right course of treatment for you and determine what is safe, appropriate and effective based on your needs. Reliance on any information provided by Journey or in connection with the Services is solely at your own risk. You are solely responsible for any decisions or actions you take based on the information and materials available through the Services.

You acknowledge that although some content may be provided by individuals in the medical profession, the provision of such content does not create a medical professional/patient relationship between you and Journey or between you and any other individual or entity, and does not constitute an opinion, medical advice, or diagnosis or treatment. Healthcare providers and patients should always obtain applicable diagnostic information from appropriate trusted sources. Healthcare providers should never withhold professional medical advice or delay in providing it because of something they have read in connection with our Services.

THE SERVICES SHOULD NEVER BE USED AS A SUBSTITUTE FOR EMERGENCY CARE. IF YOU HAVE A MEDICAL OR MENTAL HEALTH EMERGENCY, ARE THINKING ABOUT SUICIDE OR TAKING ACTIONS THAT MAY CAUSE HARM TO YOU OR TO OTHERS, YOU SHOULD SEEK EMERGENCY TREATMENT AT THE NEAREST EMERGENCY ROOM OR DIAL 911.

State Law Privacy Rights ‍

California Resident Rights ‍

Under California Civil Code Sections 1798.83-1798.84, California residents are entitled to contact us to prevent disclosure of Personal Information to third parties for such third parties’ direct marketing purposes; in order to submit such a request, please contact us at info@journey.clinic.‍

Nevada Resident Rights ‍

If you are a resident of Nevada, you have the right to opt-out of the sale of certain Personal Information to third parties who intend to license or sell that Personal Information. You can exercise this right by contacting us at info@journey.clinic with the subject line “Nevada Do Not Sell Request” and providing us with your name and the email address associated with your account. Please note that we do not currently sell your Personal Information as sales are defined in Nevada Revised Statutes Chapter 603A. ‍

General Data Protection Regulation (GDPR)‍

We do not knowingly collect Personal Information about individuals residing in the European Union.  If you believe that we have collected or processed Personal Information about an individual residing in the European Union, please contact us at info@journey.clinic. ‍

What choices do I have? ‍

You can always opt not to disclose information to us, but keep in mind some information may be needed to register with us, to join our network or to take advantage of some of our features.

You may be able to add, update, or delete information as explained above. When you update information, however, we may maintain a copy of the unrevised information in our records. Some information may remain in our records even if you request deletion of such information from your account. We may use aggregated data derived from or incorporating your Personal Information after you update or delete it, but not in a manner that would identify you personally.

Contact Information ‍

If you have any questions or comments about this Privacy Policy, the ways in which we collect and use your Personal Information, your choices and rights regarding such use, please do not hesitate to contact us at: www.journeyclinical.com or info@journey.clinic.

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Consent for Psychiatric Medication Management (with Ketamine Consent)

JOURNEY CLINICAL PSYCHIATRY PC
JOURNEY CLINICAL PSYCHIATRY CA PC
JOURNEY CLINICAL PSYCHIATRY TX PC

By signing below, you consent to receive psychiatric medication management services through Journey Clinical Psychiatry PC and/or Journey Clinical Psychiatry CA PC (“Journey”).  Psychiatric medication management services may involve psychiatric medications such as, but not limited to,  ketamine, SSRIs (Selective serotonin reuptake inhibitors), SNRIs (serotonin and norepinephrine reuptake inhibitors), TCAs (Tricyclic antidepressants), MAOIs (Monoamine oxidase inhibitors), Atypical antidepressants, other anxiolytics, mood stabilizers, benzodiazepines, stimulants, hypnotics and additional agents as applicable.  Your Journey provider will discuss with you all of the medication options available to treat your current condition. Your Journey provider will present information in language that you can understand.  You will learn how the medication works, its dosage, frequency, expected benefits, possible side effects, drug interactions, and any withdrawal affects you may experience if you stop taking the medication abruptly.  By the end of the discussion, you will have all the information you need to make an informed decision as to which medication is right for you.

You acknowledge that patients will have varying success in treatment depending on the severity of their complaints and not everyone is a good candidate for psychiatric medication management.  Psychiatric medication management requires strict adherence to dosage and frequency, close follow-up, and sometimes regular blood tests. Your ability to adhere to medication treatment will be taken into consideration in your Journey provider agreeing to provide you with medication management services. You understand that, although your Journey provider may conclude that certain psychiatric medications may help you, there are no guarantees that your condition will improve from psychiatric medication management. You understand that sometimes a patient may have to try several different psychiatric medications before they experience an improvement in symptoms. 

You acknowledge that some possible treatments may not be approved by the FDA for treatment of your specific condition, and that this off-label use may have additional risks along with uncertain benefits. You are aware of and understand the risks of this treatment and that there may be limited evidence for potential benefits. With this knowledge, you have choosen to participate in this treatment.

You understand that psychiatric medications can have significant side effects which your Journey provider has discussed with you. You understand that medication treatment could have effects on your brain, body, consciousness, emotions, actions, sleep, memory, judgment, coordination, stamina, and sexuality. You confirm that you will review information about any given treatment and will ask your provider any questions or clarify any concerns. You also confirm that you have been given an opportunity to decline any suggested treatment. 

You hereby waive any and all claims against Journey or your treatment provider, including any additional members, directors, officers, employees, agents, or related parties of Journey or your provider, for the use of such treatments in your psychiatric care. This agreement will also be directed to your heirs and assigns. You voluntarily enter this agreement, waiver, and release to allow your treatment with any potential off-label and not FDA-approved uses of medications along with their indicated uses. This agreement, waiver, and release pertains to various medications which may be prescribed as part of your treatment.

Ketamine Consent

Overview

Ketamine is a dissociative class compound, with an FDA schedule III designation. It is indicated for and commonly used as an anesthetic medication. Ketamine has been found to be helpful for treating depression, even in individuals who have not responded to other interventions. It has a unique effect, in that it can work very rapidly, with individuals frequently seeing improvement in their depression within hours. However, ketamine response is not guaranteed and even in responders, the therapeutic effect from a single treatment is time-limited, with relapse typically occurring within a span of several days to one or two weeks in the absence of concomitant maintenance strategies.

Maintenance strategies must therefore be employed to extend the duration of the treatment response to a meaningful length of time.  In severely symptomatic patients, this is most often accomplished by administering a series of ketamine treatments in relatively close succession (for example, severely symptomatic patients often receive 4 to 6 treatments spaced out over two to three weeks), which has been shown to extend the duration of effect, from a span of days to weeks, up to a span of weeks to months, in some cases even longer. Concomitant use of psychotherapy and / or conventional antidepressant medication in conjunction with ketamine pharmacotherapy has also been shown to prolong the duration of treatment effect in recent studies. Less symptomatic patients may not require as many or as frequent ketamine sessions to sustain therapeutic effect, as those who are more severely symptomatic and impaired.

The ongoing beneficial effects that can result from ketamine treatment include general mood improvement, lessening of anhedonia and reduction/resolution of suicidal ideation. Improvements in levels of anxiety and behavioral patterns of sleep, appetite and energy can also be realized. Ketamine has also demonstrated benefit in anxiety conditions, including PTSD, and may improve patterns of obsessive thinking or rumination. Coupling these biological effects with psychotherapy and behavioral change is designed to maximize the depth and duration of these benefits.

Off-label use

Ketamine does not have an indication for treatment of depression, anxiety or any other psychiatric condition by the FDA. Therefore, the provision of ketamine for these conditions is an ‘off-label’ use. This is a legal prescribing practice and occurs quite commonly – up to 20% of prescriptions written every year in the US are for off-label indications, by some measures. Two examples among many include the use of tricyclic antidepressants for pain and antihistamines for insomnia.

Mechanism

The most current evidence indicates that ketamine operates chiefly on the glutamate neurotransmitter system in the central nervous system (i.e. brain and spinal cord), which consists of the neurotransmitter glutamate and its two principal receptor molecules located on the surface of nerve cells, known as the NMDA receptor (NMDA-R) and AMPA receptor (AMPA-R).  Ketamine exerts its effects by both stimulating the release of glutamate into the neuronal synapse (the space that exists between two brain cells (neurons) that are adjacent to and hence in communication with one another) and antagonizing the binding of glutamate at the NMDA-R on the post-synaptic neuron. This has the effect of shunting glutamate preferentially through the AMPA-R system. This in turn triggers a cascade of intracellular events that ends with the upregulation of another neurotransmitter, BDNF, at key sites in the brain associated with executive functioning, memory and emotion regulation.

Increased levels of BDNF promote the formation of new synapses in these areas, which promotes the formation of new circuits between and among neighboring neurons, ultimately enhancing overall brain functioning and flexibility. This effect is termed an enhancement of the brain’s ‘neuroplasticity’, which is to say the brain’s ability to form novel connections among its constituent neurons, and hence novel patterns of thinking, feeling and behaving, in response to environmental stimuli.  Enhancement of neuroplasticity produces both an intrinsic antidepressant response and creates a window of time during which the brain is more responsive to interventions such as psychotherapy, which ultimately felt to contribute strongly to the acute and ongoing effects of treatment.

Route of Administration

Ketamine can be administered in a variety of ways: via an intravenous ketamine infusion (IV), an intramuscular injection (IM), a subcutaneous injection (SC) intranasally, orally and sublingually as a dissolving wax troche or rapid dissolving tablet. Routes vary in the onset of action, bioavailability (i.e. how much is absorbed into the systemic circulation) and clearing time through the system for each individual. While there is generally a predictable response based on past administration, it is possible that patients may experience variable physiological and subjective experiences with the same dose.

Source: The Ketamine Papers, Chapter “Intravenous Ketmamine Steven P. Levine MD”, p 292

Footnote 1: derived from Journey Clinical Psychiatry, PC (“Journey”) clinicians’ private practice experience

Ketamine has an elimination (beta) half-life of 2.5 hours. Its acute subjective effects, however, are mediated by its alpha half-life of 10-15 minutes, which is the time it takes for ketamine to cross into the brain and back out into the systemic circulation across the blood-brain barrier. It is excreted through the kidneys. A small percentage is unchanged, while the majority is converted, upon circulation through the liver, into its primary active metabolites, norketamine and hydroxynorketamine, which may play an additional role in mediating the antidepressant effects and can be detected in the urine for up to a week after treatment.

Dosing protocols

There are a variety of dosing protocols in practice. The initial wave of research into ketamine’s antidepressant effects has been largely focused on the provision of 0.5mg/kg of ketamine by IV infusion over 45 minutes, in a repeated series consisting of 2/week for 3 weeks, often in the office of an anesthesiologist. In this model, the treatment effect relies predominantly on ketamine’s intrinsic pharmacologic properties, with little attention paid to the role of concomitant psychotherapy in leveraging ketamine’s neuroplasticity-enhancing effects in the time immediately after and between treatments.

More recent protocols have been explored and described in the literature, which include provision of ketamine by a sublingual or intramuscular route in the presence of a psychotherapist, with the express intention of leveraging not only ketamine’s intrinsic antidepressant effects, but also the enhancement of brain neuroplasticity, in order to render psychotherapeutic interventions more effective and long-lasting.  

Effect

Ketamine effects can be designated as occurring at time of dosing–i.e. acute–and ongoing–i.e. beyond the time it takes for ketamine to be metabolized and excreted, noting that longer acting metabolites persist up to a week.

The acute subjective effects of ketamine dosing can range from sub-perceptual disturbances in cognitive processing and body sensation to full dissociative states in which one feels separate from the body and thoughts dissolve fully. Research evidence suggests that some level of dissociation may be correlated with treatment response for depression.

These experiences are classified as non-ordinary states of consciousness, and may represent novel experiences for patients. It is possible that some patients may experience a departure from their usual mind and physical state as challenging or unsettling in the moment. The treatment environment, supportive therapist stance and dosing protocol is designed to optimize the positive nature of the subjective experiences induced by ketamine.

Initial dosing (i.e. 100-200mg sublingual ketamine) is designed to place patients in a ‘trance’ state that is often described as a “glass of wine effect”.  At higher doses (i.e. 300-800mg sublingual ketamine), the dissociative effect becomes more pronounced, and patients may experience more ego-transcendent types of experiences, which some people describe as spiritual, and these can also be profoundly therapeutic in some cases.

Depending on the patient’s experience and the desired effects, dosing can be adjusted upward or downward over the course of subsequent treatment sessions, in consultation with the ketamine prescriber.

Ketamine-Assisted Psychotherapy

The outcome of Ketamine-Assisted Psychotherapy, like all psychedelic-assisted psychotherapy modalities, is greatly influenced by factors summarized as the ‘set and setting’ of the experience. ‘Set’ refers to the mindset, or internal environment, of the experiencer of the non-ordinary state of consciousness produced by the psychedelic; this includes the experiencer’s beliefs, intentions, emotional state, etc. ‘Setting’ refers to the external environment in which the experiencer is located at the time of the psychedelic-assisted psychotherapy session; this includes not only the physical aesthetics of the environment itself, which are important, but also the interpersonal dynamics that exist between the experiencer and anyone else in the space, such as their therapist, the experiencer and therapist’s culture, etc.

In this implementation model, ketamine is dosed in a comfortable office setting, using sublingual lozenges in the form of a rapid dissolving tablet or wax-based troche.  A peaceful, safe, calming environment characterized by trust between patient and therapist, and entered into with the proper set of intentions, beliefs, expectations and so on, can set the stage for an experience that can be significantly more therapeutic than pharmacologic treatment alone, particular when pharmacologic treatments are conducted in highly sterile, medicalized environments such as anesthesiologist’s clinic, as they nowadays often are.

Additionally, when these conditions are met, the non-ordinary states of consciousness induced by the ketamine frequently provide for more material to work with in therapy than is ordinarily the case with unassisted psychotherapy alone, especially in the context of a long term psychotherapeutic relationship.

This treatment model is offered after evaluation of a patient’s response to medication, psychotherapy, and the appropriateness of other, more conventional treatment modalities – e.g., in the case of depression, SSRIs / SNRIs, ECT, TMS, etc. The patient has a right to refuse or discontinue ketamine treatment at any point during the treatment course. The expected outcome from treatment may vary from non-response to a robust and sustained response. There are adverse effects potentially associated with the treatment, discussed below. Long-term maintenance of benefit from treatment may require ongoing ketamine dosing, ongoing unassisted psychotherapy, use of other medications, or some combination of all of these. On the other hand, a single or subsequent dosing of ketamine does not automatically imply the need for ongoing provision of this treatment.

Medical clearance for treatment:

In addition to its psychological and anesthetic effects, ketamine also has ‘sympathomimetic’ properties, which means it acts to mimic some of the effects of the sympathetic branch of the autonomic nervous system.  In practical terms what this means is that it has the effect of elevating both blood pressure and heart rate. Typically these elevations are relatively mild (10-20 mmHg increases in both systolic and diastolic blood pressure; 10-20 bpm increases in heart rate) and brief (30-90 minutes, depending on dose and route of administration). As such, for a person with healthy cardiovascular status, ketamine poses very little risk in this regard, exerting a stress on the cardiovascular system roughly equivalent to mildly vigorous physical exercise, such as running briskly up a flight of stairs.

Prior to administration of ketamine, you will be evaluated by your prescriber, a medical professional, who will interview you and review your medical and psychiatric history, in order to identify factors that may place you at higher risk of adverse effects from a ketamine dosing experience. From a medical standpoint, risk-conferring conditions are generally chronic conditions that are vulnerable to exacerbation into states of acute instability by the sympathomimetic effects of ketamine, because even mild and transient elevations in blood pressure and heart rate can destabilize conditions such as poorly controlled hypertension, poorly controlled glaucoma, poorly controlled arrhythmias, etc.

For the same reason, your evaluating clinician will instruct you to refrain from the use of other sympathomimetic medications, such as stimulants (e.g., Adderall, Ritalin, etc.), on the day of a ketamine treatment session, so as to avoid any additive sympathomimetic effects.

Another potential risk of ketamine, unrelated to its sympathomimetic effects, is its propensity to cause bladder inflammation and dysfunction, although serious and permanent bladder damage has only been reported in people in situations where ketamine is used very frequently at high doses for a prolonged period of time, such as in someone suffering from ketamine addiction.  While the pattern of dosage and frequency used in ketamine infusion therapy or ketamine-assisted psychotherapy does not cause bladder irritation in most people and has never been reported to cause severe or permanent bladder damage, people with a history of bladder problems (e.g., cystitis), might be more prone to suffering bladder irritation when receiving ketamine. This irritation is rare and is typically mild and transient, but for some people it can be distressing enough to outweigh the benefits of ketamine treatment.

In some cases, the evaluating medical professional may determine that a patient requires consultation with another medical specialist, such as a primary care physician, a cardiologist or a urologist, to either inform the decision of whether it would be safe to proceed, or to initiate treatments targeted at controlling conditions that are elevating risk, e.g. performing an EKG to evaluate the current status of someone with a history of cardiac arrhythmia, initiating antihypertensive medication for someone with poorly-controlled hypertension, or recommending prophylactic treatment to minimize the symptoms of ketamine-associated cystitis.

Ketamine is typically not recommended for use during pregnancy due to a lack of data from controlled studies in humans. For this same reason, the Federal Drug Administration has not assigned a pregnancy risk category to ketamine. Because it currently remains unclassified, it is best to avoid ketamine use while pregnant or breastfeeding unless, upon discussion with your prescribing clinician, it is determined that the benefits far outweigh the risks, which is not inconceivable but would be a relatively rare circumstance.

Adverse and side effects associated with treatment:

As described above, ketamine increases sympathetic tone in the vasculature and can raise blood pressure and heart rate, which has associated risks with adverse outcomes linked to stroke and arrhythmias, resulting in loss of function and possibly death.

Ketamine exhibits very minimal suppression of respiratory drive, however it is rarely reported to cause laryngospasm, although this is extremely rare outside of pediatric populations, and has only been reported at relatively high doses administered by intramuscular or intravenous injection.

Ketamine has a risk of abuse, i.e. escalated use despite adverse outcomes. It generally has low reinforcement properties (such as those observed with stimulants) and no physiological withdrawal syndrome (such as that observed with opiates or benzodiazepines). Therefore, it is atypical for patients to crave use and demonstrate behaviors to obtain it, although some people may develop a psychological craving for the temporary escape and acute symptom relief that ketamine provides, particularly those who are using it outside of the context of a therapeutic relationship.  Ketamine does result in some physiologic tolerance (needing higher doses for the same effect), though this is often easily managed by planning judicious amounts of time between dosing sessions.

At anesthetic doses (1-4mg/kg dosed by IM or IV), the following side effects are most commonly reported, and may occur at lower doses, i.e. sublingual dosing of 100-200mg, but are less likely:

• drowsiness
• dizziness / lightheadedness
• impaired coordination / unsteadiness
• nausea / vomiting
• blurry vision / double vision
• feeling strange or ‘unreal’
• abnormal sensations (numbness, tingling)
• slurred speech
• headache
• dry mouth or hypersalivation
• impaired concentration / trouble concentrating
• restlessness

Effects resolve completely in nearly all patients within 2-4 hours (IM, IV, sublingual if spit), or 6-12 hours (oral or sublingual if swallowed).

From a psychiatric standpoint, ketamine confers the risk of potentiating or exacerbating symptoms of psychosis in people with a personal history of primary psychotic illness (e.g. schizophrenia or schizoaffective disorder). For this reason, patients with these diagnoses are not appropriate candidates for ketamine therapy. Unlike conventional antidepressants, ketamine has not been shown to precipitate manic episodes in people with a history of bipolar disorder if they are taking ketamine while depressed. However, ketamine can exacerbate manic symptoms in someone who is already in a state that is acutely manic or mixed (manic and depressive symptoms occurring at the same time). Patients with a history of bipolar disorder will therefore be carefully screened by their evaluating clinician to ensure they are not experiencing elements of mania prior to initiating ketamine treatment and throughout the treatment course.

Management of Adverse Effects:

Because your ketamine treatment will be taking place under the observation of a psychotherapist who is not a trained medical provider, it is important to understand that you will need to play an active role in ensuring your own medical safety during your dosing session, under the guidance of the medical provider who is prescribing the ketamine. Primarily this will consist of adhering to all the safety recommendations outlined in this document and communicated to you by your ketamine prescriber at the time of that evaluation.

Your ketamine prescriber will direct you to a video recorded by Journey Clinical that demonstrates how to correctly use a blood pressure cuff. You will be asked to measure your blood pressure and heart rate using this cuff prior to self-administration of the sublingual ketamine, and report these values to your psychotherapist, whose job it is to record them.

Based on your medical history and cardiovascular risk factors, your ketamine prescriber will provide you and your psychotherapist with upper limits for your blood pressure and heart rate measurements, above which it is recommended that you do not proceed with self-administration of ketamine.

If the initial reading of these measurements are above the parameters set forth by your prescriber, your psychotherapist may guide you through some controlled breathing exercises or other methods designed to alleviate any acute anxiety you may be feeling, which can falsely elevate blood pressure and heart rate. After this, you may re-check your blood pressure and heart rate to see if they have normalized.

If your blood pressure and heart rate have not normalized following these methods, then you agree not to proceed with self-administration of ketamine, and your KAP session will need to be canceled. It may be rescheduled only after you have sought consultation with your primary care provider for further workup and management of these vital sign abnormalities.

Your psychotherapist or your after-care/support person may activate emergency response systems, i.e. call 911, if there is any indication of a medical emergency during the course of a ketamine-assisted psychotherapy session.

With respect to nausea, approximately 10% of patients who receive ketamine by IM or IV injection will develop significant nausea; this percentage is somewhat higher when ketamine is taken by the sublingual route, especially when it is swallowed. For this reason, at the time of your initial evaluation, your ketamine prescriber will also prescribe a small supply of an anti-nausea medication called ondansetron (Zofran), and will discuss with you during your evaluation whether and when you should take it in order to minimize or prevent nausea from occurring during your ketamine experience.

Generally, if you are prone to motion sickness or to becoming nauseated from other medications, it is a good idea to take ondansetron as a preventative measure 1-2 hours prior to your first, and all subsequent, ketamine sessions. People without a known propensity for nausea may choose to forgo this precaution for their first ketamine session, to see whether it is necessary to take prior to subsequent sessions. If nausea does occur during that first dosing session, taking ondansetron during the session can help alleviate the symptoms within about 30-60 minutes, and it should be taken as a preventative measure prior to all subsequent ketamine sessions.

Preparation

Prior to treatment:

• You are encouraged to begin fasting at 12:00 midnight on the night before your session if it is in the morning, If your session is in the afternoon, you may have a light breakfast but allow 4 hours of fasting before your session. A small intake of water is permitted.
• If you need to have caffeine in the morning, please go ahead and do that, keeping in mind the 4 hour fasting guideline.
• Please do not ingest any other psychedelic/sacred medicines or chemicals for 7 days before or after a ketamine session. We want your body and your psyche to have enough time to process your experiences. Please plan your schedule accordingly.
• If it is safe for you to do so, please avoid using benzodiazepines, cannabis, opioids, alcohol and/or muscle relaxants for at least 48 hours prior to and after your session. These medications and chemicals can interfere with the effectiveness of ketamine.
• On the day of your ketamine session, please do not take any medications, such as stimulants (e.g. Adderall, Ritalin, etc) that can elevate blood pressure and heart rate. Otherwise, continue to take all of your regular medications as usual. If you are diabetic and take insulin, please adjust your insulin dose to account for your fasting state.
• If you have any questions about medications or interactions, please ask your ketamine prescriber.

Outline of a standard KAP session

Preparation: 0-15 minutes

• Evaluation of mindset and readiness for treatment.
• Blood pressure measurement, as described above.
• Confirmation that an after-care/support person is available for pick-up from office or that a chaperone is present in remote or at-home therapy settings.

Dosing: Onset 15-30 minutes

• Rapid dissolving tablet or wax troche – initial dosage based on body weight, intensity of depression, subjective evaluation of patient capacity to tolerate dissociative state, goals of treatment.
• A medicinal tasting bolus of saliva can be expected to accumulate in the mouth as the tablet or troche dissolves. Saliva should be held under the tongue for 10-15 minutes, swished around every 1-2 minutes to enhance absorption, and then, in most cases, spit out. Swallowing is permitted but is generally not recommended, as it increases the risk of nausea and prolongs states of confusion and incoordination, without any added therapeutic benefit.

Trance state: 30-45 minutes: Generally restful, volitionally non-verbal, supported by soothing music and eye shades to promote inward focus

• The ketamine experience typically begins with a heaviness in the physical body, possibly with the loss of sensation, followed by a separation from the usual state of cognitive processing.
• At a low dose range (i.e. 100-200mg sublingual), you will generally be responsive to verbal stimuli and easily able to enter alert and interactive state, and your therapist may check in on you by verbal cue from time to time to determine if there are any concerns. At a higher doses (300+ mg sublingual), you will be awake but less capable of interacting coherently with your therapist for a period of 20-30 minutes.
• Guidelines around physical contact over clothing, as well as the use of scent or aromatherapy, should be discussed between you and your psychotherapist ahead of time, with the involvement of your chaperone, as applicable, as these can sometimes be important as a form of reassurance at particularly intense moments of the experience, but should not be initiated by your therapist without your prior consent.
• While it is often described as relaxing and pleasant, some patients may experience the unfamiliarity of the ketamine state as disconcerting – perhaps in the heaviness/floating sensation, feeling of being outside of one’s body, physical discomfort (nausea or vertigo, particularly if there is a lot of physical movement before the acute effects have worn off), the presentation of distressing psychological material, and so on. Your psychotherapist is there, in part, to offer reassurance and support in the event of any kind of distress that may arise.

Early Integration Phase: 30-45 minutes: Opportunity for reflection and discussion

• As you begin to emerge from the ketamine experience and return to your ordinary waking state, you will be encouraged to describe the experience and potentially engage in discussion of the thoughts, emotional states and physical sensations that came up and are continuing to come up in response to the ketamine, though you may prefer silence in this period, which is also okay.

Disengagement from treatment

At any point in the treatment course, you may disengage from the defined and recommended process – i.e. sit up and take off the eye shades. However, by signing this consent form, you are agreeing not to leave the office of your psychotherapist until he or she feels it is safe for you to do so. You may request that your defined aftercare support person assume custody at any point during the treatment, with full release into care to be determined by the psychotherapist conducting the session.

Aftercare

• When the session ends you may still be under the influence of ketamine, so leaving with a friend or family member is necessary. This person should be identified ahead of time, and their name and contact information should be provided to your psychotherapist (there is also space for you to specify this information on this form, below).  Your chaperone will attest to your psychotherapist that you will be in their care and will release your psychotherapist and your prescriber from any liability related to your actions after you leave your psychotherapist’s office.  If you choose to leave your psychotherapist’s office without a chaperone, you will acknowledge to your psychotherapist that you are of sound mind when doing so.
• Driving an automobile or engaging in other hazardous activities should not be undertaken until a minimum of 12 hours have elapsed from the time of ketamine administration.  
• A light meal is recommended following the ketamine experience.
• Strenuous or stressful activities should generally be avoided for the remainder of the day and evening following a ketamine session.  Rest and quiet reflection are encouraged.
• The therapist will schedule a time for a brief check-in the following day in order to help you start processing your KAP experience.
• In the days and weeks that follow your first and subsequent ketamine experiences, you will be encouraged to engage in reflective, introspective exercises such as journaling, meditation, and so on, and will likely also engage in a series of one or more non-ketamine-assisted psychotherapy sessions, to help you to ‘unpack’, or integrate, the information made accessible by the experience and use it to create health-promoting and health-sustaining changes in your inner and outer life, from day to day.
• Occasionally, people may experience a headache following a ketamine session.  These headaches are generally responsive to treatment with NSAIDs like ibuprofen, naproxen, acetaminophen, which are fine to take.
• The day after a ketamine session, you are free to return fully back to your daily routine at home, school or work, and resume activities such as driving, etc, without any restrictions.
• Some people may feel somewhat activated for a day or two after their session. This is normal and temporary. If this occurs you may use the following for stabilization: reading, distraction, meditation, exercise, rest, yoga.  It will pass.  Contact your psychotherapist or your ketamine prescriber if you have concerns.

Ongoing and concurrent treatment

For the duration of your treatment relationship with your Journey prescriber, you are agreeing to remain engaged in an ongoing and concurrent treatment with a psychotherapist, who will be working in a collaborative treatment relationship with you and your prescriber. The termination or interruption of collaborative treatment will result in termination of further ketamine prescriptions from your Journey prescriber. If for whatever reason you are unhappy with your psychotherapist but would like to continue pursuing ketamine-assisted psychotherapy, let your prescriber know, as he or she may be able to facilitate connecting you with another psychotherapist.

Ketamine disposal

If you choose to discontinue KAP prior to using all of your prescribed ketamine, you acknowledge and agree that you will follow the applicable state disposal guidance for any unused ketamine.  

Telehealth visits

To enhance the quality and efficiency of your care, our practice uses an AI-powered notetaking tool during telehealth consultations. This tool transcribes and summarizes clinical conversations to assist your provider in documentation. It does not record audio; it uses speech to text to create notes for me. Your information remains confidential and is protected under HIPAA regulations. The provider will review all AI-generated notes for accuracy.

By consenting, you acknowledge that:

• Your consultation may be processed by this AI tool to create clinical notes.
• You may withdraw consent at any time by notifying your provider.
• Alternative documentation methods are available if you decline AI assistance.

Final declaration

In signing this agreement, I recognize that I have established a treatment relationship with a Journey Clinical Psychiatry PC, Journey Clinical Psychiatry CA PC, Journey Clinical Psychiatry TX PC prescriber of ketamine for ketamine-assisted psychotherapy. I understand that I have alternative treatment options beside ketamine for my condition. I understand that I may not respond or have a favorable response to ketamine treatment and there are risks, contraindications, and side effects associated with the treatment, as further described herein, some of which may be permanent.

I understand that a Journey Clinical Psychiatry PC, Journey Clinical Psychiatry CA PC, Journey Clinical Psychiatry TX PC prescriber will outline the dosing for the ketamine prescribed to me, the setting in which I should self-administer the ketamine, and the appropriate range for my vitals.  I agree that I will not self-administer the prescribed ketamine outside of these guidelines.

Treatment may be terminated by Journey Clinical Psychiatry PC, Journey Clinical Psychiatry CA PC, Journey Clinical Psychiatry TX PC based on clinical factors, including and not limited to concerns regarding poor fit with treatment, low likelihood of response, lack of adherence to treatment agreements and recommendations, concern for diversion, patient behaviors and risk factors exceeding an acceptable level of risk to patient safety, and lack of sufficient collaboration with a KAP therapist. Provision of treatment does not automatically imply future treatment.

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Journey Clinical Psychiatry Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

This Notice of Privacy Practices describes how Journey Clinical Psychiatry, P.C., Journey Clinical Psychiatry CA, PC and Journey Clinical Psychiatry, TX, PLLC (collectively, “we” or “us”), each of which are members of an affiliated covered entity (“ACE”), may use and disclose your protected health information and your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services. We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our notice at any time. The new notice will be effective for all protected health information that we maintain at that time. It will be available upon request and on our website.


1. Uses and Disclosures of Protected Health Information

Following are examples of the types of uses and disclosures of your protected health information that we are permitted to make. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that we may make.

Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination of your health care with another provider. For example, we would disclose your protected health information, as necessary, to a clinician or hospital that provides care to you, such as by providing information about your assessments and prescriptions to your other treating providers. We also may make your protected health information available to third-party health care providers by making it accessible through a health information exchange (“HIE”). This means that if one of your other treating clinicians uses an HIE that we participate in, the clinician will be able to access the protected health information generated in the course of your treatment with us, subject to all required consents. We also may access your protected health information available through the HIE to provide treatment to you, subject to any required consents.

Payment: Your protected health information will be used and disclosed, as needed, to obtain payment for your health care services provided by us or by another provider. This may include responses to inquiries regarding invoices for the health care services we provide.

Health Care Operations: We may use or disclose your protected health information in order to support our business activities, including for quality assessment, employee review, training and conducting or arranging for other business activities. We also may share your protected health information with third-party “business associates” that perform various activities for us. We will have a written contract with business associates to protect the privacy of your protected health information. We may use or disclose your protected health information, as necessary, to provide you with information about our services or other health-related benefits and services that may be of interest to you; you may contact our Privacy Officer to opt out of receiving these materials.

Affiliated Covered Entity: We, as members of an ACE, will share your protected health information with each other for treatment, payment and the health care operations of the affiliated covered entity and as permitted by HIPAA and this Notice.

Other Permitted and Required Uses and Disclosures That May Be Made Without Your Authorization or Opportunity to Agree or Object

These situations include:

Required by Law: We may use or disclose your protected health information to the extent that the use or disclosure is required by law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law.

Public Health: We may disclose your protected health information for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. For example, a disclosure may be made for the purpose of preventing or controlling disease.

Communicable Diseases: We may disclose your protected health information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.

Health Oversight: We may disclose protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies that oversee the health care system, government benefit programs, other government regulatory programs and civil rights laws.

Abuse or Neglect: We may disclose your protected health information if we believe that you have been a victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.

Food and Drug Administration: We may disclose your protected health information to a person or company required by the Food and Drug Administration for the purpose of quality, safety, or effectiveness of FDA-regulated products or activities including, to report adverse events, product defects or problems, biologic product deviations, or to track products; to enable product recalls; to make repairs or replacements, or to conduct post marketing surveillance, as required.

‍Legal Proceedings: We may disclose protected health information in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), or in certain conditions in response to a subpoena, discovery request or other lawful process.

Law Enforcement: We may also disclose protected health information, so long as applicable legal requirements are met, for law enforcement purposes.

Coroners, Funeral Directors, and Organ Donation: We may disclose protected health information to a coroner, medical examiner or funeral director to assist them in performing their legally-authorized duties.

Research: We may disclose your protected health information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information.

Criminal Activity: Consistent with applicable federal and state laws, we may disclose your protected health information, if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose protected health information if it is necessary for law enforcement authorities to identify or apprehend an individual.

Military Activity and National Security: When the appropriate conditions apply, we may use or disclose protected health information of individuals who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities; (2) for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits, or (3) to foreign military authority if you are a member of that foreign military services. We may also disclose your protected health information to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized.

Workers’ Compensation: We may disclose your protected health information as authorized to comply with workers’ compensation laws and other similar legally-established programs.

Minors: We may share a minor’s health information with the minor’s parents or guardians unless such disclosure is prohibited by state or federal law.

Uses and Disclosures of Protected Health Information Based upon Your Written Authorization

Other uses and disclosures of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law as described below. For example, uses or disclosures for certain marketing activities or that constitute a sale of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law. You may revoke any authorization in writing at any time. If you revoke your authorization, we will no longer use or disclose your protected health information for the reasons covered by your written authorization. Please understand that we are unable to take back any disclosures that you previously authorized.

Other Permitted and Required Uses and Disclosures That Require Providing You the Opportunity to Agree or Object

Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your protected health information that directly relates to that person’s involvement in your health care, if any. Finally, we may use or disclose your protected health information to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care. If you are not present or able to agree or object to the use or disclosure of the protected health information, then your caregiver may, using professional judgement, determine whether the disclosure is in your best interest.

Other Legal Requirements

State and federal laws may provide additional protection of some of your protected health information. For example, we may need to obtain your authorization or a court order to disclose certain sensitive information, such as information regarding mental health or substance use disorder treatment. We also may need to obtain your permission to disclose protected health information to certain state-sponsored registries.


2. Your Rights

Following is a statement of your rights with respect to your protected health information and a brief description of how you may exercise these rights.

You have the right to inspect and copy your protected health information. This means you may inspect and obtain a copy of protected health information about you. You may access or obtain your records, including medical and billing records and any other records that we use for making decisions about you. As permitted by federal and state law, we may charge you a reasonable copy fee for a copy of your records. If legally permitted, we may deny access to certain information, including information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding. In some circumstances, you may have a right to have this decision reviewed. Please contact our Privacy Officer if you have questions about access to your medical record.

You have the right to request a restriction of your protected health information. This means you may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment or health care operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes. We are not required to agree to a restriction except if you request to restrict disclosure of your protected health information to a health plan, if (i) the disclosure is for payment or other health care operations purposes and is not otherwise required by law and (ii) the information pertains solely to a health care item or service for which you paid us in full. If we do agree to the requested restriction, we may not use or disclose your protected health information in violation of that restriction unless it is needed to provide emergency treatment. You may request a restriction by contacting our Privacy Officer.

You have the right to request to receive confidential communications from us by alternative means or at an alternative location. We will accommodate reasonable requests. We may also condition this accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact. Please make this request in writing to our Privacy Officer.

You may have the right to request an amendment of your protected health information. In certain cases, we may deny your request for an amendment and you will have the right to file a statement of disagreement with us. We may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. Please contact our Privacy Officer about amending your medical record.

You have the right to receive an accounting of certain disclosures we have made of your protected health information. This right applies to disclosures for purposes other than treatment, payment or health care operations as described in this Notice of Privacy Practices. It excludes disclosures we may have made to you if you authorized us to make the disclosure, to family members or friends involved in your care, or for notification purposes, for national security or intelligence, to law enforcement or correctional facilities, or as part of a limited data set disclosure. The right to receive this information is subject to certain exceptions, restrictions and limitations.

You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this notice electronically.

You have the right to be notified of a breach of unsecured protected health information that affects you.


3. Complaints

You may complain to us or to the Department of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with the Department at www.hhs.gov/ocr/privacy/hipaa/complaints and with us by notifying our Privacy Officer via email at support@journey.clinic. We will not retaliate against you for filing a complaint.

This notice was published and becomes effective on March 23, 2023.

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Psychiatry Covered Entities

Journey Clinical Psychiatry, P.C., Journey Clinical Psychiatry CA, PC and Journey Clinical Psychiatry, TX, PLLC


Privacy Policy

We at Journey Clinical Psychiatry, P.C., Journey Clinical Psychiatry CA, PC and Journey Clinical Psychiatry, TX, PLLC (collectively, “Journey”) know you care about how your personal information is used and shared, and we take your privacy seriously. Please read the following to learn more about our Privacy Policy. By using or accessing our website, platform or other services (“Services”) in any manner, you acknowledge that you accept the practices and policies outlined in this Privacy Policy, and you hereby consent that we will collect, use, and share your information in the following ways. If you do not agree with the terms of this Privacy Policy, please refrain from using or accessing the Services.

What does this Privacy Policy cover?

This Privacy Policy covers our treatment of personally identifiable information (“Personal Information”) that we gather when you are accessing or using our Services, but not to the practices of companies we don’t own or control, or people that we don’t manage. We gather various types of Personal Information from our users, as explained in more detail below, and we use this Personal Information internally in connection with our Services, including to personalize, provide, and improve our services, to contact you and allow other users to contact you, to fulfill your requests for certain products and services, and to analyze how you use the Services. In certain cases, we may also share some Personal Information with third parties, but only as described below.

We do not knowingly collect or solicit personal information from anyone under the age of 13. If you are under 13, please do not attempt to register for the Services or send any personal information about yourself to us. If we learn that we have collected personal information from a child under age 13, we will delete that information as quickly as possible. If you believe that a child under 13 may have provided us personal information, please contact us at info@journey.clinic.

We do not control and are not responsible for the privacy practices of third parties, including those linked on our website or platform. We encourage you to review the privacy policies of each website and application that you visit and use.

Will Journey ever change this Privacy Policy?

We’re constantly trying to improve our Services, so we may need to change this Privacy Policy from time to time as well, but we will alert you to changes by placing a notice on www.journeyclinical.com, by sending you an email, and/or by some other means. Please note that if you’ve opted not to receive legal notice emails from us (or you haven’t provided us with your email address), those legal notices will still govern your use of the Services, and you are still responsible for reading and understanding them. If you use the Services after any changes to the Privacy Policy have been posted, that means you agree to all of the changes.

What Information does Journey collect and how is it used?  

We receive and store any information you knowingly provide to us. For example, if you schedule an appointment online or contact us with comments or questions, we will collect Personal Information such as your name, date of birth, mailing address, phone number and email address. Certain information may be required to register with us or to receive Services. We may communicate with you if you’ve provided us the means to do so. For example, if you’ve given us your email address, we may send you information regarding our Services or email you about your use of the Services. Also, we may receive a confirmation when you open an email from us. This confirmation helps us make our communications with you more interesting and improve our services. If you do not want to receive communications from us, please indicate your preference by sending an email to info@journey.clinic.

We also use your information to provide Services to you, to provide you with customer support, to develop, test and improve our Services, to identify and create new services and to improve user experiences.

THE SERVICES SHOULD NEVER BE USED AS A SUBSTITUTE FOR EMERGENCY CARE. IF YOU HAVE A MEDICAL OR MENTAL HEALTH EMERGENCY, ARE THINKING ABOUT SUICIDE OR TAKING ACTIONS THAT MAY CAUSE HARM TO YOU OR TO OTHERS, YOU SHOULD SEEK EMERGENCY TREATMENT AT THE NEAREST EMERGENCY ROOM OR DIAL 911.

Will Journey share any of the Personal Information it receives?

We may choose to buy or sell assets, and may share and/or transfer account, contact, and other Personal Information in connection with the evaluation of and entry into such transactions. Also, if we (or our assets) are acquired, or if we go out of business, enter bankruptcy, or go through some other change of control, Personal Information could be one of the assets transferred to or acquired by a third party.

We may de-identify your Personal Information so that you are not identified as an individual, and provide that information to our partners. We may also provide aggregate usage information to our partners (or allow partners to collect that information from you), who may use such information to understand how often and in what ways people use our Services, so that they, too, can provide you with an optimal online experience.

In some circumstances, we employ other companies and people to perform tasks on our behalf and need to share your information with them to provide products or services to you; for example, we may use a third-party mail management service to send you emails on our behalf. Unless we tell you differently, our agents do not have any right to use the Personal Information we share with them beyond what is necessary to assist us.

We reserve the right to access, read, preserve, and disclose any information that we reasonably believe is necessary to comply with law or court order; enforce or apply this Privacy Policy and other agreements; or protect the rights, property, or safety of Journey, our employees, our users, or others.

Protected Health Information

Journey is a “covered entity” under the Health Insurance Portability and Accountability Act of 1996 and its implementing regulations (“HIPAA”). Certain of the Personal Information that you may provide to us may be “protected health information,” as defined in HIPAA. We may use and disclose your protected health information as described in our HIPAA Notice of Privacy Practices. In addition, any medical or health information that you provide that is subject to specific protections under applicable state laws will be used and disclosed only in accordance with those laws.

Is Personal Information about me secure?

We endeavor to protect the privacy of your Personal Information we hold in our records. While we take strict measures to protect information, we cannot guarantee complete security, such as from unauthorized entry or use, hardware or software failure, and other factors that may compromise the security of user information.

State Law Privacy Rights  

California Resident Rights

Under California Civil Code Sections 1798.83-1798.84, California residents are entitled to contact us to prevent disclosure of Personal Information to third parties for such third parties’ direct marketing purposes; in order to submit such a request, please contact us at info@journey.clinic.

Nevada Resident Rights

If you are a resident of Nevada, you have the right to opt-out of the sale of certain Personal Information to third parties who intend to license or sell that Personal Information. You can exercise this right by contacting us at info@journey.clinic with the subject line “Nevada Do Not Sell Request” and providing us with your name and the email address associated with your account. Please note that we do not currently sell your Personal Information as sales are defined in Nevada Revised Statutes Chapter 603A.

General Data Protection Regulation (GDPR)

We do not knowingly collect Personal Information about individuals residing in the European Union. If you believe that we have collected or processed Personal Information about an individual residing in the European Union, please contact us at info@journey.clinic.

What choices do I have?

You can always opt not to disclose information to us, but keep in mind some information may be needed to receive Services.

You may be able to add, update, or delete information as explained above. When you update information, however, we may maintain a copy of the unrevised information in our records. Some information may remain in our records even if you request deletion of such information from your account. We may use aggregated data derived from or incorporating your Personal Information after you update or delete it, but not in a manner that would identify you personally.

Contact Information

If you have any questions or comments about this Privacy Policy, the ways in which we collect and use your Personal Information, your choices and rights regarding such use, please do not hesitate to contact us at: www.journeyclinical.com or info@journey.clinic.

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Patient Financial Responsibility and Acknowledgement

I understand that by signing this Patient Financial Responsibility Agreement, I consent to the terms and conditions set forth below regarding the medical [and/or psychotherapy] services, including psychedelic therapies (the “Therapies”), that I receive from providers using the Journey Clinical, Inc. (“Journey”) platform, including physicians, therapists, and nurse practitioners employed or engaged by Journey Clinical Psychiatry, P.C., Inc., Journey Clinical Psychiatry CA, P.C., and Journey Clinical Psychiatry, TX, PLLC [and affiliated psychotherapists] (“Providers”).

I acknowledge and agree as follows:

• While Journey itself is not a Provider, Journey is responsible for providing the administrative function of billing for all services provided by Journey-affiliated Providers.
• If I have a health insurance policy that I plan to use to receive covered medical services (“Covered Services”) from Providers affiliated with Journey, I have provided Journey with the most updated and correct information about my insurance. If I provide Journey with incorrect or not current information about my insurance, I will be fully responsible for any and all charges for the cost of services, including the Therapies, provided to me through the Journey platform.
• I assume full financial responsibility and agree to pay for all charges for Covered Services that are not paid by insurance, including co-payments, co-insurance and/or deductibles and expenses of every kind and description for all Covered Services provided to me by Providers affiliated with Journey.  I know that this includes all payments required under my insurance plan.  I agree it is my responsibility to confirm that the Providers affiliated with Journey are participating providers under my health insurance policy.
• I acknowledge that certain components of the Therapies, including, but not limited to, administration of psychedelics, observation and monitoring, may not be covered by insurance (“Non-Covered Services”) and that I am solely financially responsible for any Non-Covered Services.
• Payment for any and all charges related to Covered and Non-Covered Services from Journey or Providers affiliated with Journey will be due either prior to the beginning of my session or immediately thereafter, as instructed by Journey.  If I receive any bill from Journey or a Journey-affiliated Provider for amounts due that have been unpaid, I agree to pay any such bill within the stated reasonably expected time.
• Journey accepts most major credit cards and payments via its third-party online payment processing vendor.
• If I have a health insurance policy, I have carefully read the section in my health insurance policy that describes Covered Services. If I have questions about my coverage, I will call the plan administrator to ask questions and clarify my benefits. I am responsible for knowing which services my insurance plan will and will not cover and my financial responsibility (out-of-pocket charges). It is my responsibility to have obtained any and all necessary referrals and authorizations required prior to receiving medical services from Providers affiliated with Journey. If my insurance company requires a referral and I do not have one, then I understand that I will be responsible for all the costs and fees associated with the services I receive (as further discussed below).
• I may incur additional charges at the discretion and reasonable notice of Journey, including without limitation charges for credit card payment processing fees, missed appointments without notice per Journey’s policies, which are subject to change, and any costs associated with the collection of unpaid balances.
• I authorize Journey and Providers affiliated with Journey to release my medical and other information acquired in the course of my examination and/or treatment to the necessary insurance companies, other third-party payors, and/or other physicians or healthcare entities required to participate in my care.
• I authorize assignment of my insurance benefits to be paid directly to Journey and Providers affiliated with Journey for any services rendered as allowable under standard insurance and other third-party payor contracts.  I understand I am financially responsible for charges not covered by this assignment.  If I receive payment from my insurance plan for benefits due to Journey or its affiliated Providers for my care, other than as reimbursement for payments I have already made, I agree to promptly sign the payment to Journey, or pay that amount to Journey directly.
• As a courtesy to its patients, Journey is pleased to assist in the submission of insurance claims to certain insurance plans for payment. Currently, Journey-affiliated Providers participate with and bill the health plans identified in our FAQs. Journey also provides the list of insurers and the states we participate in as part of your signup process with Journey.  

I understand that I am personally responsible to pay for my care received via the Journey platform for non-covered services, if I do not have insurance, Journey does not participate in my health insurance plan or my insurance does not pay for my care because:

• My health plan requires my primary care physician to give me a written referral before a Journey-affiliated Provider treats me and I did not get a referral;
• My health plan denies payment for these services and leaves me responsible for payment;
• My health plan decides that services I received via the Journey platform are not medically necessary and/or Non-Covered Services;  
• My health plan coverage has lapsed or expired at the time I receive services via the Journey platform; or
• I have chosen not to use my health plan coverage.

I understand that the terms herein are contractual and not a mere recital and that I sign this document as my own free act and void of any coercion.

I understand that clicking “I Agree” constitutes a legal signature and verifies that I have read all of the information contained in this Patient Financial Responsibility Agreement.

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Patient Code of Conduct

In the context of psychedelic-assisted therapy, patients understand the importance of adhering to a set of principles and guidelines to ensure a safe, respectful, and effective therapeutic experience. The Patient Code of Conduct draws inspiration from the Professional Practice Guidelines outlined by the American Psychiatric Nurses Association (APNA) and the Psychedelic-Assisted Psychotherapy Code of Ethics provided by the Multidisciplinary Association for Psychedelic Studies (MAPS). By committing to the following code, patients contribute to the success of their therapeutic journey and cultivate a therapeutic environment that prioritizes well-being.

Commitment to Your Care:

• Patients will commit to actively participating in treatment by openly expressing thoughts, feelings, and experiences to facilitate a collaborative and trusting relationship with their Journey Clinical member therapist and the Journey Clinical Medical team.

Respect:

• Patients will respect the professional boundaries set by their Journey Clinical member therapist and the Journey Clinical Medical Team, and adhere to the agreed-upon structure of the therapeutic sessions.
• Patients understand that they must uphold a respectful and ethical demeanor with all Journey Clinical stakeholders including Journey Clinical member therapists, the Journey Clinical Medical team, and staff.

Safety and Well-being:

• Patients will prioritize their physical and emotional safety during and after psychedelic-assisted therapy sessions.
• Patients will promptly communicate any concerns or adverse effects experienced during or after sessions to their therapists and report them via the Journey Clinical portal.

Informed Consent

• Patients will actively participate in the informed consent process, seeking clarification on any uncertainties regarding the therapeutic approach, potential risks, and benefits.

Compliance with Therapeutic Recommendations and Medical Protocols:

• Patients will diligently follow any therapeutic recommendations provided by their therapists and strictly adhere to the Journey Clinical Medical team protocols and treatment plan to maximize the effectiveness and safety of the treatment. Protocols and treatment plans include pre-session preparation, vital sign monitoring pre- and post-treatment sessions, dosing and administration, and safety precautions.
• Patients will adhere to participating in integration sessions following each treatment session to facilitate the integration of insights gained during psychedelic sessions into their daily lives.

Open Communication and Transparency with Your Care Team:

• Patients will actively engage in open, collaborative, and honest communication with their Journey Clinical member therapists and the Journey Clinical Medical Team, providing accurate information about their medical history, mental health, and any substance use.
• Patients will communicate openly about their thoughts, feelings, and experiences during therapy sessions, fostering a collaborative and trusting therapeutic relationship.
• Patients will provide feedback to their therapists regarding the therapeutic process to enhance the quality of care.

Notification of Changes in Health:

• It is the responsibility of patients to promptly notify their therapists and the Journey Clinical Medical Team if any changes in their life circumstances may affect their health since their last session. This includes but is not limited to new medications, medical procedures, or significant health events.

Respect for Fellow Participants in a Group Setting:

• Patients will respect the experiences and privacy of fellow participants in group therapy settings, refraining from judgment or disclosure of personal information shared during sessions.
• Patients will contribute to creating a supportive and non-judgmental therapeutic community.
• Patients will maintain the confidentiality of the therapeutic process, respecting the privacy and anonymity of fellow participants.

Non-Discrimination and Cultural Sensitivity:

• Patients will embrace and respect the diversity of individuals, therapists, and Journey Clinical Medical team members participating in psychedelic-assisted psychotherapy, recognizing and valuing differences in culture, ethnicity, gender, and background.
• Patients will refrain from engaging in any form of discrimination or prejudiced behavior during therapy sessions and medical consultations.

Continuous Self-Reflection:

• Patients will engage in ongoing self-reflection to enhance their self-awareness and contribute positively to the therapeutic process.
• Patients will openly discuss challenges and progress with their therapist and the Journey Clinical Medical team, fostering a collaborative approach to their personal growth.

Termination of Therapy:

• Patients understand that they have the right to terminate therapy at any time and will openly communicate their decision with their therapists and the Journey Clinical Medical Team.
• In the event that patients' therapists determine the need to terminate therapy, patients will respect their professional judgment and collaborate on a suitable termination plan.

Awareness of Patient Rights:

• Patients understand their rights and will communicate to their Journey Clinical member therapist and/or Medical Team to report any breach of their rights.
• Rights include:
  
  • Patients have the right to respectful and compassionate care, free from abuse, mistreatment, harassment, or exploitation.
  • The right to clear and understandable information about diagnoses, treatment, potential effects, risks, benefits, and alternative treatment options.
  • The right to grant, withhold, or withdraw consent to treatment, including the use of touch, and the right to refuse participation in research or educational activities.
  • The right to ask questions and receive satisfactory answers before, during, and after treatment.
  • The right to non-discrimination based on race, gender, gender identity, expression, appearance, physical abilities, religion, culture, age, sexual orientation, or socioeconomic status.
  • The right to privacy and confidentiality, including information about the limitations of confidentiality and knowledge of any individuals involved in discussing their case.
  • The right to reasonable continuity of care and transparent information about fees and payment procedures.
  • The right to a designated advocate, an advance directive, and information about emergency care procedures.
  • The right to be informed about the people providing treatment, their licensure, qualifications, and training.
  • The right to participate in the treatment plan decisions whenever possible.

By adhering to this Patient Code of Conduct, patients commit to fostering a therapeutic environment that prioritizes safety, respect, and collaboration, supporting the clinical outcomes of psychedelic-assisted psychotherapy for themselves and their fellow participants.