Privacy Policy

Consent for Treatment w/ Dr. Lisa Walker, PsyD

* indicates a required field

Thank you for considering Quilted Rose Clinical Services for your consulting, coaching or clinical mental health needs. As a client, you have the right to decide if our services are suitable for your needs at any time. This document is designed to inform you about Dr. Walker’s professional credentials, therapeutic orientation, fee schedule, and your rights as a client. I encourage you to voice any concerns that you may have at any time while we are working together.


Dr. Walker received her Master's in Counseling from Wayne State University and a doctorate in clinical psychology from Argosy University in San Francisco. She has twenty years of experience providing therapy to adolescents and adults. Dr. Walker is licensed as a Licensed Professional Counselor in Michigan (LPC# 6401010055). Each of the individual therapists that work in Dr. Walker’s practice have provided their credentials on the “About Us” page.

Dr. Walker has worked as a clinician and in leadership positions in private child welfare settings, hospitals, residential, outpatient and criminal justice settings. Dr. Walker is a trauma and recovery specialist (trained TF-CBT (for use with adolescents), BrainSpotting and EMDR), a trained LLPC supervisor and a consultant to organizations providing trauma-informed care and cultural responsibility trainings.

Theoretical Orientation:

Dr. Walker works with all Black (LGBTQ+ inclusive and affirming) people; with a special emphasis on adults who work in the health, education and nonprofit sectors. She works collaboratively to facilitate growth in individuals struggling with intergenerational trauma, complex trauma, acute stress, depression, anxiety and stopping the cycle of unhealthy relationships all while maintaining within a society which thrives on systemic oppression.

Each of the individual therapists that work in Dr. Walker’s practice have provided their respective theoretical orientations on the “About Us” page.

Telehealth Therapy:

Distance counseling has become the norm for many, if not most, client - professional relationships. To engage in telehealth with Dr. Walker a stable internet connection, email, and a credit/debit card are needed to participate. You must also have your camera on and in a stable location (not driving or in any moving vehicle) throughout the entirety of each session. It is also strongly recommended that you utilize a computer, laptop or tablet as opposed to phone. Finally, it is your responsibility to ensure, on your end, that you are in a location where your session cannot be overheard by others. If you must be in a semi-shared location, headphones are required to increase privacy and to decrease background noise.

Before our first meeting, I will provide instructions for connecting to a secure, HIPAAcompliant telehealth platform.


I will keep confidential anything you say as part of our counseling, consulting and or coaching relationship, with the following exceptions:

  • You direct your mental health professional with Quilted Rose Clinical Services in writing to disclose information to someone else.
  • Your mental health professional is ordered by a court to disclose information.
  • Abuse of Children or Elderly Persons: If a mental health professional reasonably believes that a child under the age of 18 or an elderly person is being abused or neglected, they are legally obligated to report this situation to the appropriate state agency.
  • Imminent Harm to Self: If a mental health professional reasonably believes that you are in imminent danger of physically harming and if you are unwilling or unable to follow treatment recommendations, they may have to make an involuntary referral to a hospital and/or contact a family member or other person who may be able to help protect you.
  • Imminent Harm to Others: If your mental health professional reasonably believes that you are an actual threat to the safety of another person, they may be required to take some action (such as contacting the police, notifying the other person, seeking involuntary hospitalization, or some combination of these actions).

In those rare instances where it is necessary for your mental health professional to disclose information relating to your counseling without your permission, mental health professional will make every effort to fully discuss it with you. However, when mental health professional is required to disclose your records pursuant to a court order issued under the Patriot Act, your mental health professional be prohibited by the terms of the order from notifying you of the disclosure.

There are two other instances your mental health professional may also be released from the confidentiality rule. One is if there is a charge brought against me to the licensing board or in court, I am allowed to use all information to defend themselves. The second is if a patient does not pay the bill for therapy, after reasonable efforts at collections your mental health professional is allowed to involve legitimate collections activity by other parties, which will release information such as dates of service, charges, payments and balances necessary for the collections process.

Dual Relationships:

The relationship you and your mental health professional share is a professional one, and should not be confused with a friendship or one of a social nature. It is against any mental health therapist's ethical code to participate in a client's life beyond the professional role before, during, or after the client receives services. In order to protect your privacy as well as that of your mental health professional, please understand that they cannot accept invitations to social gatherings or social media.

Together, let's discuss a plan for how we will handle accidental run-ins in public. My general rule of thumb is to take your lead in public, and never make first contact in order to respect your privacy. Also, due to ethical guidelines and respect of our working relationship, please understand that your mental health professional is unable to accept gifts of any kind.

In Case of Emergency:

Please be aware that Quilted Rose Clinical Services does not have office staff. For routine messages, scheduling, questions, or to let them know that you need to speak about some routine matter, you may leave a message on their confidential voicemail or via the HIPAA complaint messaging platform within SimplePractice. You may choose to use text messaging, but please be aware of the risk of this since it is not guaranteed to be confidential.

Due to their work schedules, your mental health professional with Quilted Rose is often not immediately available by telephone. Your mental health professional does not answer the phone during sessions. Therapists with Quilted Rose check for messages frequently and makes every effort to return calls or message within a 24-hour period of your contact, with the exception of weekends and holidays or when your mental health professional has indicated that they will be away from the office for extended periods of time.

You may also contact Dr. Walker by email at or any of the other therapists with Quilted Rose at their respective email addresses found on the “About Us” page. Please be aware that email may not be secure. Therefore, only use it for limited purposes such as scheduling and general questions. Please do not include sensitive information in an email and never use it in an emergency.

If you have an urgent situation that you feel needs immediate support, please contact one of the following:

  • Detroit Mobile Crisis, 313-258-3842
  • National Suicide Prevention Lifeline; 1-800-273-TALK (8255)
  • LGBTQ Youth Suicide Hotline; 1-866-4-U-TREVOR (487-3867)
  • Visit your Primary Care Physician or go to the nearest hospital emergency room.
  • Contact emergency services, 911

Complaint Procedures:

The State of Michigan requires counselors to adhere to a specific Code of Conduct that is determined by the Board of Counseling. Please feel free to speak with your mental health professional directly if you are offended or dissatisfied with any part of your counseling experience so the issues can be address together. Direct, honest communication is an essential component of the therapeutic relationship.

Should you wish to file a complaint, you may do so through: Michigan Department of Licensing and Regulatory Affairs Health Professions Division Enforcement Section
P.O. Box 30670
Lansing, MI 48909
(517) 373-9196

Session Fees and Length of Service:

My fee for a 50 minute session is $125 each session. Session fee is billed at the time of service. No refunds are given if sessions are terminated by the client (either by no-show or discussed termination) prior to the use of pre-paid sessions. Dr. Walker accepts PayPal ( and all major debit and credit cards directly through the SimplePractice portal. Dr. Walker does raise fees periodically. When there is any change in fees schedule, they will notify you in advance.

Cancellation Policy:

If you are unable to keep an appointment, please contact (text, email or portal message) your mental health professional within 24 hours to cancel or reschedule. You will be charged the full fee of $125 for missed appointments unless you cancel or reschedule 24 hours prior to your scheduled appointment. Dr. Walker accepts PayPal (, and all major debit and credit cards directly through the SimplePractice portal. Dr. Walker will provide a receipt for all fees paid. A fee of $35.00 will be charged for all insufficient funds transfers. Finally, after 2 missed sessions (or if the intake session is missed) you will be removed from Dr. Walker's list of current (active) clients (i.e. you will be discharged from services with Quilted Rose Clinical Services, PLLC). You will receive a final bill for any unpaid services as well as referral options.

Services will be rendered in a professional manner consistent with ethical standards. It is impossible to guarantee any specific results regarding your counseling, consulting or coaching goals as the outcome is dependent on the largely unpredictable nature of behavioral health care. However, together we will work to achieve the best possible results. Referral to another counselor or service will be mutually discussed if progress is not achieved at a satisfactory level or in the event that additional services may be in your best interest.