Welcome to my practice. The information on this page will assist you in making an informed decision concerning the use of my services. I am happy to discuss any questions you have regarding the information and policies provided.

1. Qualifications: I am a Registered Nurse licensed in the state of Texas since 1996. I comply with the Texas Nursing Practice Act, the Patient Bill of Rights and continuing education requirements. Through advanced education I have received two certifications in clinical nutrition: Certified Clinical Nutritionist (CCN) and most recently Applied Clinical Nutritionist (ACN).

2. Consultations: To schedule your initial phone consultation, please save and complete this Pre-Consult Questionnaire, providing as much background information as you like, then email it as an attachment to ros@roshaney.com. I will confirm receipt of your questionnaire and schedule our initial session. Please contact me by phone or email if you have not heard from me within 2 business days.

A thorough evaluation of your questionnaire will occur before our phone visit so that a prioritized plan is presented. You will receive individualized, practical methods that you can easily incorporate into each day to improve you and your spouse�s reproductive health. My role is to help you sort through the maze of information to determine what is most appropriate for your health and recovery.

I cannot guarantee you a pregnancy or a healthy child. What I do offer is an improved chance for a pregnancy and a lifelong interest in the nutritional well-being of yourself and your family.

3. Fees:

One-hour phone consultations are $150. This includes:

• time prior to our phone visit in which I evaluate your questionnaire so that we begin our phone consultation with a plan of action.
• time following our phone visit in which I email a summary of my priority recommendations
• one week of emails following our phone consultations to assure that all recommendations are thoroughly understood and all questions are answered

Use the Paypal button below to purchase a One-hour phone consultation:

Thirty-minute phone consultations are $75.

• Simply email your list of questions and the best time on a Tuesday or Wednesday to reach you and I will confirm a thirty minute phone visit.

Use the Paypal button below to purchase a Thirty-minute phone consultation:

Consultation packages are $300 and include a One-hour phone consultation plus 3 Thirty-minute follow-up phone consults for the price of 2. This is a $75 savings. Two Consultation packages are available:

• Fertility or nutrition package: One hour initial consult and three 30 minute follow-up consults.
• Pregnancy package: One hour 1st trimester consult scheduled as soon as you know you are pregnant, a 30 minute consult at the start of your second and third trimesters and a free post-partum consult to assure the needs of your own health and recovery are being met along with those of your child.

Use the Paypal button below to purchase a phone Consultation package:

If cancellation is necessary, please give 48 hours notice by phone or e-mail (no text messages please) as provided above and there will be no charge.

4. Confidentiality: Please read the enclosed Notice of Privacy Practices – Short Form. If you have any questions or would like a full legal copy of HIPAA please contact me. All transactions and records are kept strictly confidential. Your records may be released only when requested in writing by you, or when required by law. Under the HIPAA privacy rule patients are given the right to request confidential communications. Please notify me of updates to the following information.

5. Primary Physician Care: You will continue to consult your primary care physician or seek the advice of a specialist if your primary care physician or Rosalind Haney advises you to do so. For this you take full responsibility.

Notice of Privacy Practices – Short Form

The privacy of your medical information is extremely important to me. I have a legal duty to keep your medical information private and to follow all patient privacy laws and regulations.

I may legally use your information in the following ways:

• For your medical treatment
• For payment purposes if you choose to submit to insurance (this is required by insurance to process billing)
• For healthcare operations as necessary for licensure and credentialing
• Facility directory (general information only, no medical records) for administrative purposes
• Emergency situations
• Disaster relief efforts
• In-office research (in limited circumstances and with permission)
• For funeral directors, medical examiners and organ procurement organizations as necessary and allowable by law
• For public health associations where required by law
• For court orders and Judicial and Administrative proceedings as required by law
• For specialized government functions as required by law
• In situations of abuse, neglect or domestic violence as required by law
• For worker’s compensation
• Health oversight activities
• Law enforcement as required by law
• Appointment reminders

I may not disclose any personal or medical information for any other reason or to any other person or organization. I will honor your privacy.

For a full legal copy of the notice of privacy practices or if you have any questions or concerns regarding the above, please contact me.

- Rosalind Haney, R.N., A.C.N.

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