The term “client” refers to the individual receiving psychological testing and other psychological services. In some cases, the term “client” may refer to a Medicare beneficiary or a legal representative, as applicable.

The term “consenting adult” refers to the individual with legal authority to consent to psychological testing of the client, including: (1) a biological or adoptive parent with legal custody, (2) a court-appointed legal guardian, (3) an individual appointed to hold educational rights by a juvenile court or (4) an adult client (age 18 or older) consenting on their own behalf. By signing this form, the consenting adult attests that they have legal authority to consent to psychological testing of the client.

The term “family” is used to refer to the client, the consenting adult and, when applicable, other household members involved in the psychological testing process.

In cases of shared legal custody of a minor or dependent adult, consent from one individual with legal custody is generally sufficient to authorize psychological services, unless a court order requires joint consent for psychological testing or other psychological services. If there is a dispute regarding custody or guardianship, the consenting adult must disclose this information to Dr. Pratt before services begin. If there are potential legal disputes, custody issues or parental conflict, the full fee is due at the end of the initial meeting if the family proceeds with psychological testing. Pre-payment for services preserves Dr. Pratt’s neutrality in the conflict.

Parents or guardians with legal custody are entitled to receive copies of the evaluation report and to participate in meetings to discuss results, regardless of whether they were the consenting adult for this contract. If a court order specifically restricts one parent’s access to psychological records, the consenting adult must provide a copy of that order to Dr. Pratt before services begin.

Dr. Pratt is not on call, and he may not be available for clinical emergencies. If there is a client crisis that cannot safely wait for a response, promptly call 911 or go to the nearest hospital. Dr. Pratt can be contacted by email at This email address is being protected from spambots. You need JavaScript enabled to view it.. Dr. Pratt will attempt to respond quickly; however, there may be significant delays in responding.

Dr. Pratt follows ethical guidelines of the American Psychological Association. He complies with laws and regulations related to work as a licensed psychologist, including those of the California Board of Psychology. If there is a concern with services at The Pratt Center, please speak to Dr. Pratt. He will attempt to resolve matters directly, but the family also has the right to contact the California Board of Psychology at 866-503-3221.

Dr. Pratt accepts payments made through QuickBooks Online or checks payable to The Pratt Center. Fees for services generally adjust annually, and returning clients will be required to sign an updated psychological testing consent form to receive services.

If the family decides to terminate testing before it is completed, billing will include services provided prior to termination, and the deposit remainder, if any, will be refunded. Dr. Pratt does not issue a final written report unless all aspects of psychological testing are completed because partial testing may yield invalid results or erroneous diagnostic impressions. However, in accordance with California law, some records remain available for inspection upon written request, regardless of the report status. 

There are other services aside from psychological testing that are billed separately, and fees for these services are payable at the time of service. The initial school meeting to present testing results is included in the testing fee; however, subsequent school meetings are billed separately from testing. Each school meeting is billed as a separate service based on the length of the meeting at Dr. Pratt’s hourly rate. Given that a typical school meeting lasts about two hours, a good faith estimate of the cost is $620. 

Dr. Pratt reserves the right to assign billings to collection agencies if accounts are more than ninety days past due. The family is responsible for legal fees and other costs related to the collection of outstanding accounts.

Dr. Pratt does not accept insurance or comply with insurance company policies, and he will not respond to correspondence from insurance companies. That is, he does not call, write or email insurance companies. Insurance companies set the rules for reimbursement, and Dr. Pratt cannot provide any assurance that services will be covered. He is not on any provider panels and does not have a National Provider Identification (NPI) number. Dr. Pratt will not enter contracts with insurance companies, including single-case agreements. He does not complete insurance forms, regardless of the type of form (e.g., pre-authorization forms, treatment plans, etc.). 

Insurance companies often do not cover psychological testing services. In addition, they are unlikely to reimburse fees that they do not deem medically necessary (e.g., school meetings, school observations, travel time, record review, academic achievement tests, legal proceedings, etc.). Insurance companies do not generally reimburse video and telephone sessions. 

Dr. Pratt may provide an itemized invoice to the family. The Pratt Center Employer Identification Number (EIN) is listed on the invoice. Dr. Pratt will not include, delete or alter information on an invoice to qualify for or increase reimbursement. To receive an invoice, the family must request the invoice from Dr. Pratt directly. Dr. Pratt may provide one invoice per service, and he does not divide invoices when there are two households. 

The federal No Surprises Act went into effect on January 1^st, 2022, and it provides protection against “surprise billing.” Dr. Pratt is an out-of-network provider who does not accept insurance, and this consent form serves as notice that insurance companies are unlikely to reimburse for psychological testing and other psychological services he provides. That is, the family can expect to pay the full amount in the good faith estimate provided in this consent form. Testing is billed at a flat rate and insurance reimbursement is not expected, so billing surprises are unlikely to occur. However, the good faith estimate is only an estimate, and actual services and charges may differ from the estimate. If an invoice is at least $400 higher than the good faith estimate, the law provides a process for disputing the invoice within 120 days. More information about the No Surprises Act can be found at www.cms.gov/nosurprises.

Telehealth services, including phone consultations and video meetings, are offered as a convenience to facilitate communication and may be used for certain evaluation components, such as consultation and feedback sessions. Please be advised that as a psychologist licensed exclusively in the State of California, Dr. Pratt is authorized to provide psychological services only to clients physically located within California at the time services are rendered. This limitation applies regardless of the family’s state of residence. If the family will be outside of California during a scheduled telehealth appointment, please notify Dr. Pratt in advance so the meeting can be rescheduled. If appropriate to the client’s needs, a protocol will be established to address emergencies in which telehealth services are interrupted or unavailable. The client has been informed of the difference between in-person and telehealth services and has been given the opportunity to ask questions.

Initial meetings, final meetings, parent consultations and school meetings are completed by video conference. Video meetings are generally held using a video conferencing platform with end-to-end encryption. Dr. Pratt may use a range of video conferencing platforms depending on technological options and client preference. If a school or school district holds a meeting by video conference, the family may invite Dr. Pratt to attend. The family accepts the risks inherent to all online video technology, including the risk of a data breach. There may be issues with internet connectivity, hardware, software or equipment. A data breach may relate to the video platform policies and practices, issues with their technology or third-party intrusion into their system. Regardless of the cause, the family agrees that The Pratt Center is not responsible for data breaches or other issues related to video conferences. Under California’s all-party consent law, recording confidential communications without the consent of all parties is illegal. The family is prohibited from recording any meetings with Dr. Pratt, except school meetings. IEP team meetings may be audio recorded if the family gives 24-hour advance written notice to the appropriate school personnel.

The address of Dr. Pratt’s principal place of business is 14375 Saratoga Avenue, Suite 204, Saratoga, CA 95070, and testing sessions are completed in person at this location. Testing sessions are typically ninety minutes in length, and about seven testing sessions are needed. However, clients vary in their clinical needs and processing speeds, and most tests are untimed. Hence, the actual number of testing sessions needed varies widely. All testing sessions needed are included in the standard rate for testing.

Any health and safety limitations to in-person meetings will be listed on The Pratt Center website at www.prattcenter.com. There is no fee for late cancellations. To reduce spread of disease, clients should stay home if they have any signs of illness. Testing will be invalid if a client is not feeling well.

Dr. Pratt does not supervise clients in the hallways, stairways, restrooms, sidewalks or parking areas. There are potential hazards, including street traffic and staircases, that may require parental supervision.

Dr. Pratt conducts assessments in accordance with professional standards and legal requirements for nondiscriminatory evaluation. Testing is conducted in English. If the client’s primary language is not English or if the client has limited English proficiency, the family should discuss this with Dr. Pratt during the initial meeting. Depending on the client’s needs, Dr. Pratt may:

• Select assessment instruments with appropriate normative data
• Use nonverbal measures where appropriate
• Note language considerations in the interpretation of results
• Refer the client to a bilingual evaluator if Dr. Pratt cannot provide a linguistically appropriate assessment.

Standardized tests are administered according to publisher guidelines to ensure valid results. Some accommodations are generally permitted under standardized administration procedures, such as frequent breaks. For students with physical, sensory or other disabilities that may affect standardized test administration, Dr. Pratt will select appropriate instruments and note any modifications in the report. Results will be interpreted with consideration of how the disability may have affected performance. If an accommodation might invalidate test norms, it will be noted and results will be interpreted accordingly. The family should inform Dr. Pratt of any sensory impairments, such as hearing or vision, which may affect test administration so that appropriate instruments can be selected.

Dr. Pratt may hire professional writers or testing technicians who assist with the psychological testing process and work under the direct supervision of Dr. Pratt. These employees of The Pratt Center may score standardized tests, which are then carefully reviewed by Dr. Pratt. Testing technicians and professional writers do not interpret test results, formulate diagnoses or have direct contact with clients. Dr. Pratt is the only employee of The Pratt Center who administers tests to or meets with clients. Dr. Pratt retains sole professional responsibility for interpreting all data, formulating clinical diagnoses and writing the final psychological testing report.

The Pratt Center is not a covered entity under the Health Insurance Portability and Accountability Act (HIPAA) because The Pratt Center does not bill insurance companies electronically. While The Pratt Center is not a covered entity under federal HIPAA regulations, Dr. Pratt strictly adheres to the California Confidentiality of Medical Information Act (CMIA). This state law provides rigorous protection for sensitive mental health information, often exceeding federal standards.

Information shared with Dr. Pratt is generally confidential and may be legally privileged; however, there are exceptions to confidentiality that are allowed or mandated by law. If an exception to confidentiality appears to apply, Dr. Pratt will inform the family. Although this list is not exhaustive, the following are exceptions to confidentiality:

• Suspected abuse of a child, elder or dependent adult
• Danger to self or others
• Grave disability
• Childhood victim of a crime
• Legal proceedings by court order
• Malpractice lawsuit
• Medicare audit
• Mediation for No Surprises Act
• Investigation of criminal cases by law enforcement officials
• Ethics or licensing complaints

Dr. Pratt is a mandated reporter under the California Child Abuse and Neglect Reporting Act and the Elder and Dependent Adult Civil Protection Act.

If a client communicates a serious threat of physical violence against a reasonably identifiable victim, Dr. Pratt has a duty to make reasonable efforts to warn the victim and to notify a law enforcement agency. In addition, if Dr. Pratt determines there is a probability of imminent physical injury to the client or others, or a probability of immediate mental or emotional injury to the client, Dr. Pratt may disclose confidential mental health information consistent with the California Confidentiality of Medical Information Act.

There is generally no privilege in a legal case in which the client’s mental status is at issue, such as a disability determination. State and county health department guidelines and contact tracing may lead to disclosure of confidential information.

Records may be released pursuant to a valid subpoena or court order. If Dr. Pratt receives a subpoena for records, he will notify the family (unless prohibited by law) to allow the family the opportunity to seek a protective order.

Dr. Pratt reserves the right to share all information with other staff or contractors of The Pratt Center as needed to perform their job functions (e.g., president, bookkeeper, accountant, professional writers, testing technicians, lawyer, etc.). All employees at The Pratt Center receive training and an employee handbook regarding safeguarding of confidential information.

Dr. Pratt is not a special education lawyer or an educational advocate, and he gives his professional opinion as a licensed psychologist. Dr. Pratt’s role is to provide an objective, independent evaluation. His conclusions are based on clinical findings and are not influenced by the preferences of any party. If retained to testify, Dr. Pratt will provide a candid expert opinion, which may or may not support the retaining party’s position. That is, Dr. Pratt provides his professional opinion, regardless of whether it supports the position of the school district, client or family.

Dr. Pratt attends school meetings by video conference. He consults with the family and school personnel regarding the educational needs of the client. These services may include attendance at school meetings, school observations and placement recommendations. Dr. Pratt will generally audio record IEP meetings to ensure there is an accurate record and to allow participants to listen without needing to take notes. The family is responsible for providing 24-hour advanced written notice to the appropriate school personnel so that the meeting can be recorded with consent of all parties; otherwise, recording is not generally permitted.

Dr. Pratt provides psychological testing, clinical diagnosis and consultation regarding special education eligibility. Dr. Pratt does not provide: (1) special education services, (2) psychotherapy, (3) behavioral intervention services, (4) educational advocacy services or (5) legal advice. When attending school meetings, Dr. Pratt’s role is to present and explain psychological testing results objectively. If the family is seeking advocacy services or legal representation, they should consult with an educational advocate or a special education attorney.

Psychological testing reports provided to school districts become part of the student’s educational record and are thereafter governed by the Family Educational Rights and Privacy Act (FERPA) and California Education Codes. Dr. Pratt’s retention obligations apply to records maintained by The Pratt Center; the family should contact the school district directly regarding educational records in the district’s possession.

Psychological testing may or may not result in a clinical diagnosis. A clinical diagnosis under DSM-5-TR is neither necessary nor sufficient for special education eligibility. Under federal law and California regulations, special education eligibility requires that: (a) a student meets criteria for one or more disability categories, and (b) the disability adversely affects educational performance such that the student requires specially designed instruction. For example: 

• A student may meet DSM-5-TR criteria for Autism Spectrum Disorder but not qualify under the educational category of Autism if the condition does not adversely affect educational performance. 

• A student may meet DSM-5-TR criteria for Specific Learning Disorder but not qualify under Specific Learning Disability if the IEP team determines the student does not require specially designed instruction.

 The term “educational performance” under California law encompasses more than just academic achievement. It also includes functional performance, social-emotional development, communication and other areas affected by disability.

Conversely, a student may qualify for special education services without meeting full DSM-5-TR diagnostic criteria if the student meets educational eligibility standards under IDEA and California Education Code.

Under federal law and California Education Code, parents have the right to request an Independent Educational Evaluation (IEE) at public expense if they disagree with an assessment conducted by the school district. Upon receiving such a request, the district must either: (a) fund the IEE without unnecessary delay, or (b) file for due process to demonstrate that its own evaluation was appropriate. The following terms apply to the family if they are seeking public funding for an IEE completed through The Pratt Center: 

• Pratt does not contract with school districts, does not negotiate fees with districts and does not pursue collections from districts on behalf of the family. 

• The Pratt Center requires payment directly from the family, regardless of whether the family will be reimbursed by a school district. 

• Districts may propose “cost caps” or maximum allowable rates for IEEs. These caps may be lower than the prevailing rates charged by local psychologists and may be lower than Dr. Pratt’s fees. 

• The family is responsible for: (a) paying Dr. Pratt’s full fee, (b) seeking reimbursement from the district if appropriate and (c) paying any difference between the district’s reimbursement and Dr. Pratt’s fee if applicable. 

• The family is responsible for payment even if the district denies reimbursement, delays payment, or disputes the IEE request through due process. 

When an evaluation is provided to a school district as part of an IEE, Dr. Pratt provides clinical findings and uses professional opinions to inform this process, but he does not control eligibility decisions. Although the IEP team must consider independent results, there is no guarantee that the team will reach a consensus regarding eligibility or the student’s educational needs.

Dr. Pratt is a licensed psychologist who completes independent evaluations. His role is to provide objective, accurate assessment findings and professional opinions based on clinical data. His conclusions are determined by the evaluation results—not by the preferences or litigation positions of any party. When providing consultation or testimony, Dr. Pratt will offer his candid professional opinion, which may or may not support the position of the family, school district or any attorney. 

The family should understand that hiring Dr. Pratt does not guarantee opinions favorable to their case. Dr. Pratt is not a special education attorney or educational advocate. He provides professional opinions as a licensed psychologist. If the family is seeking legal advice, they should consult with a special education attorney. The family may request Dr. Pratt’s testimony at a legal proceeding, including but not limited to special education due process hearings, mediations, depositions, civil proceedings, or other administrative or judicial proceedings. The following apply to testimony fees: 

• Testimony and testimony preparation is billed at $372 per 60 minutes (equivalent to $310 per 50-minute session). There is a minimum charge of four hours ($1,488) for any scheduled court or hearing appearance, regardless of whether Dr. Pratt is called to testify. 

• A $6,000 deposit is required before Dr. Pratt begins testimony preparation. The good faith estimate for testimony is $6,000 but may be higher for cases involving extensive record review. Additional fees would apply if testimony lasts more than one day. 

• Pratt does not testify on a contingency fee basis. Testimony fees apply regardless of which party calls Dr. Pratt to testify or the outcome of the proceeding. Review of records, attorney consultations and testimony preparation are billed separately at the same rate. 

• If testimony is canceled, billing will apply to services rendered, and the remainder will be refunded. If testimony occurs, any unused deposit will be refunded, or additional fees will be billed. 

Dr. Pratt will comply with valid subpoenas and court orders. The family understands that if this evaluation becomes relevant to legal or administrative proceedings: (1) the psychological report and underlying records may be subpoenaed or otherwise become part of the official record; (2) Dr. Pratt may be called to testify by any party; and (3) Dr. Pratt’s testimony will reflect his honest professional opinions, which may or may not support any party’s position. 

The family agrees that Dr. Pratt may speak openly with the client’s attorney about all matters. During attorney consultations and testimony, Dr. Pratt’s candid professional opinion will be provided, regardless of whether it supports the client’s case, a school district’s case or any attorney arguments.

The terms and provisions of this Medicare Private Contract for Services apply only to a client who is eligible for Medicare or who becomes eligible during the period in which the client receives services from Dr. Pratt. This Medicare Private Contract for Services is between Dr. Pratt and the client (Medicare beneficiary or legal representative). 

Dr. Pratt has never participated in the Medicare program, and the undersigned client hereby agrees to forego reimbursement from Medicare for all past, present and future services provided by Dr. Pratt. The client resides at the address listed below and is a Medicare Part B beneficiary seeking services covered under Medicare Part B pursuant to Section 4507 of the Balanced Budget Act of 1997. 

Dr. Pratt has informed the client that he has opted out of the Medicare program effective on January 1, 2016. Dr. Pratt is not excluded from participating in Medicare Part B under Sections 1128, 1156, 1892, or any other section of the Social Security Act. The client agrees, understands and expressly acknowledges the following: 

• The client accepts full responsibility for payment of Dr. Pratt’s charges for all services that he furnishes and acknowledges that the client will not submit a Medicare claim for services. 

• The client understands that Medicare limits do not apply to what Dr. Pratt may charge for items or services furnished by him. 

• The client agrees not to submit a claim to Medicare or to ask Dr. Pratt to submit a claim to Medicare. 

• The client understands that Medicare payment will not be made for any items or services furnished by Dr. Pratt that would have otherwise been covered by Medicare if there was no private contract and a proper Medicare claim had been submitted. 

• The client enters into this contract with the knowledge that the client has the right to obtain Medicare-covered items and services from clinicians and practitioners who have not opted out of Medicare, and the client is not compelled to enter into private contracts that apply to other Medicare-covered services furnished by other clinicians or practitioners who have not opted out. 

• The client understands that Medi-Gap plans do not, and that other supplemental plans may elect not to, make payments for items and services not paid for by Medicare. 

• The client acknowledges that the client is not currently in an emergency or urgent health care situation. 

• This private contract for services shall be made available to the Centers for Medicare and Medicaid Services (CMS) upon request.

Psychological records are retained in accordance with the California Business and Professions Code. For minor clients, records are retained for a minimum of seven years after the client reaches age eighteen. For adult clients, records are retained for a minimum of seven years after the final date of service. Records may be retained longer at Dr. Pratt’s discretion. In accordance with the California Health and Safety Code, the consenting adult (or adult client) may request access to psychological records. Requests must be submitted in writing to Dr. Pratt.

Psychological records are generally available to parents of minors, legal guardians, adult clients and conservators as applicable, unless a law, regulation or court provides otherwise. In some cases, records may be withheld to protect the safety of the client. Raw test data and protocols are released only to qualified professionals consistent with the APA Ethics Code and test publisher guidelines. Test protocols may not be copied by the family due to test security requirements and trade secret protections.

The Pratt Center is the owner of all materials created or used in providing services to clients. Materials include paper charts, testing protocols, consent forms, developmental questionnaires, psychological testing reports, letters and other physical documents. Materials also include digital records, including but not limited to emails, slides, audio recordings, video recordings, voicemails, databases, reports and electronic chart notes.

Electronic communications might include emails, cell phone calls, voicemail messages, text messages, video calls and other forms of electronic communication. Even with appropriate security, all electronic forms of data storage and communication have risks that may compromise confidentiality. The Pratt Center uses third-party cloud-based platforms for test scoring, scheduling, billing, file storage, video conferencing and other services.

These vendors maintain their own security protocols. The Pratt Center does not control the security measures taken by any separate companies, and the family agrees not to hold The Pratt Center liable for damages related to a data breach of confidential information.

If the family uses social media in connection with The Pratt Center, that activity may not be confidential. Facebook likes, LinkedIn connections, Yelp reviews and similar online activities are visible to others.