The following information is provided for you as a resource outlining our office policies. We strive to provide state-of-the-art, patient-centered behavioral health care supported by privacy-protected technology and outstanding customer service. I hope this information will answer most questions you might have about our practice.

Office Location
830 W. South Boundary St. Suite A
Perrysburg, OH 43551
P: 419-931-3020
F: 419-931-3022
Office Hours
The reception desk will be open Monday through Thursday from 9:00 a.m. to 4:00 p.m. Contact the front desk should you require assistance outside of the scheduled office hours.
Appointments
Patients are seen by appointment only. Every effort is made to keep appointments running on schedule. Please be aware that emergencies occasionally arise which may cause unexpected delays. If this occurs, we will make an effort to notify you prior to your appointment. We ask that you help us by being on time for your appointment and by calling if you will be late or unable to keep your appointment.
The initial evaluation with Dr. Burrow & Associates will last approximately one hour. After the evaluation, if it is determined that Dr. Burrow & Associates can provide the services you need, the frequency and scheduling of appointments will be determined during this assessment.
Contacting Our Office
Please call the office if you have any questions about your appointment, medications, or treatment. Our office staff, will answer the questions, if possible. If they are unable to answer your question, they will consult with Dr. Burrow & Associates and return your call. Any messages left on our voicemail will be answered by the next business day.
Professional Fees
See Fee Schedule
A credit Card is required to be kept on file. This will be used for all charges including missed appointments and appointments cancelled without giving 24-hour notice.
Billing and Payments
Payment is expected at the time of service. A credit card will be saved on file for future transactions/balance. (Insurance Copay. Deductible, Self Pay Office Fee and Balance Payment)
Julia Burrow MD & Associates are not liable for any fees associated with credit card processing.
Upon request, a receipt and/or insurance statement can be provided. Reimbursement for out-of-network benefits will be your responsibility.
A $30.00 service charge will be added to your account for all returned checks.
Prescriptions
A prescription may be sent to your pharmacy on the day you are here. You will generally not be given another prescription before seeing your provider for a follow-up visit. Please take your medication as directed and keep up with your quantity. Please be sure you have enough to last until your next appointment. At times our office may call to reschedule an appointment. If we should call you, please check your medications to be sure you have enough to last until the date you return. Your medication is important and we do not want you to run out as this could be medically dangerous and sometimes life-threatening. It may take up to 24-48 hours from the time of your call to get your prescription refilled (48-72 hours on Fridays or holiday weekends).
Professional Records
The law and standards of the mental health profession require that Dr. Burrow & Associates keep treatment records. You are entitled to have access to your records. Because these are professional records, they can be misinterpreted and/or upsetting to untrained readers. If you wish to see your records, it is recommended that you review them with Dr. Burrow & Associates so that you can discuss the contents. Certain requests for information will incur a fee depending on the professional time spent responding to your request.
Confidentiality
In general, the law protects the privacy of all communications between a patient and a mental health professional, and this office can only release information about you and your treatment to others with your written permission. There are some exceptions including the following:
- In some legal proceedings involving child custody and those in which your emotional condition is an important issue, a judge may order my testimony if he/she determines that the issues demand it.
- Obligation to take action in a situation where Dr. Burrow & Associates have to protect others from harm. For example, if the provider believes a child, elderly person, or disabled person is being abused or neglected, she must file a report with the appropriate state agency.
- If a patient threatens to harm himself/herself or others, the provider may be obligated to arrange hospitalization for him/her or contact family members or others who can help provide protection. This rarely occurs, however, if it does, she will make a good faith effort to fully discuss it with you before taking any action.
Doctor/Patient Relationship
Dr. Burrow & Associates makes a special effort to explain all aspects of your problem and treatment. However, if something is not clear, please do not hesitate to ask. The providers respect professional boundaries at all times and practices in accordance with the highest of ethical principles and standards. If you have any suggestions or concerns, please feel free to discuss them with your provider.
Termination of the Provider/Patient Relationship
If you are contemplating terminating our relationship, please inform the provider in advance. Although difficult, talking about termination can uncover key issues in your treatment and facilitate great progress; dropping out of treatment without discussion is a lost opportunity. If you have concerns, please feel free to bring them to the providers attention so that together we can address them.
Under certain circumstances Dr. Burrow & Associates may decide to terminate the relationship. This is a rare occurrence but is important when an unexpected conflict of interest arises or if it is believed you would be better served by a different provider. This decision will only be reached after careful consideration and
discussion with you. Written notification will be provided.
Thank you for reviewing this important document. If you have questions about any of these policies or procedures, please discuss with your provider.