Patient Disclosures

Licensure

Counseling services are provided by Robert Samczuk, Licensed Professional Counselor (LPC), Texas License #85027, through Wayfarer Strategic Counseling, PLLC. The practice is regulated by the Texas Behavioral Health Executive Council and the Texas State Board of Examiners of Professional Counselors.

Notice to patients & filing a complaint

If you have a concern about services you have received, you may contact the Council directly using the information below:

Complaints must be submitted on the Council's approved complaint form, available on the How to File a Complaint page.

Your right to a Good Faith Estimate

(Notice under the federal No Surprises Act)

You have the right to receive a "Good Faith Estimate" explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don't have insurance or who are not using insurance an estimate of the bill for medical items and services.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call the practice at 972-275-9885.

Telehealth Disclosure

Wayfarer Strategic Counseling, PLLC provides services exclusively via telehealth (secure, real-time video) to adults located in the State of Texas at the time of service. Telehealth makes care more accessible, but it has limitations you should understand:

• Telehealth is not appropriate for psychiatric emergencies or for individuals who require a higher level of care.
• You are responsible for being in a private, safe location with a reliable internet connection during sessions.
• Technology may occasionally fail; if a connection is lost, we will follow a backup plan agreed upon in advance (typically a phone call).
• The same confidentiality protections and legal limits that apply to in-person counseling apply to telehealth.
• You have the right to decline telehealth and seek in-person services from another provider at any time.

The specific platform used is selected for its security and HIPAA considerations. Detailed informed consent for telehealth is reviewed and signed before services begin.

Safety and Emergency Procedures

This practice provides scheduled outpatient psychotherapy. It does not provide emergency services, crisis intervention, or after hours coverage, and the counselor is not available between sessions for urgent matters.

Because sessions take place by video, certain information is required before treatment begins so that help can reach you if it is ever needed. At intake you will provide the physical address where you will ordinarily attend sessions, a telephone number where you can be reached if the connection drops, and the name and telephone number of a person who may be contacted in an emergency. At the start of each session you will be asked to confirm where you are located and that you are somewhere private. This takes a moment and it is a standard part of responsible telehealth practice.

If a connection is lost during a session, the counselor will attempt to reconnect and will then telephone you at the number on file.

There are limited circumstances in which information may be shared without your authorization, including when there is reason to believe you or another person is at imminent risk of serious harm. These circumstances are described in full in the informed consent documents you review before beginning services.

If you are experiencing a mental health emergency, do not wait for a scheduled session. Call 988, Text HOME to 741741, call 911, or go to your nearest emergency room.

Emergencies

This practice does not provide emergency or crisis services and does not offer 24-hour coverage. If you are experiencing a mental health emergency, call or text 988 (Suicide & Crisis Lifeline), call 911, or go to your nearest emergency room. Additional resources are listed on the Contact page.

This page is provided for general information and is not a substitute for the formal informed-consent and policy documents you will review before beginning services. Last reviewed: 2026.