• Clients must have access to a reliable internet/WiFi connection and a computer (preferred), tablet, or smartphone with a functioning camera.
   
• Sessions will be conducted through our HIPAA-compliant client portal. A registration link will be provided.
   
• It is the client’s responsibility to ensure their device and internet connection are functioning properly prior to each session.
   
• If a client is unable to connect due to personal technical difficulties, the session will be charged in full.
   
• If the clinician experiences technical/network failure, the session will be rescheduled at no additional cost.
   

• All video sessions are conducted through a HIPAA-compliant, password-protected platform.
   
• Myofunctional Spot takes every reasonable precaution to maintain compliance with the Health Insurance Portability and Accountability Act (HIPAA).
   
• However, absolute confidentiality cannot be guaranteed due to inherent risks of internet-based communication (e.g., interruptions, third-party access, loss of data security).
   
• By participating in teletherapy, clients acknowledge and accept these risks and consent to treatment under these conditions.
   

• We are licensed to provide speech-language pathology services in Florida and California.
   
• Clients located in these states receive therapy services eligible for billing under speech-language pathology codes.
   
• Clients located outside of Florida or California may only receive consultative coaching services. These are not considered speech-language pathology treatment, are not eligible for Superbills, and are not reimbursable by insurance.
   
• In-office sessions are available for local clients.
   

• Parental or legal guardian consent is required for all minors receiving teletherapy services.
   
• A parent or legal guardian must be present at the start of each teletherapy session to check in the child, confirm consent, and ensure the environment is safe and appropriate.
   
• Depending on the child’s age, maturity, and treatment plan, the parent/guardian may be required to remain present during the session to assist with participation, exercises, or redirection.
   
• Parents/guardians are responsible for ensuring that the minor’s teletherapy environment is private, safe, and free from distractions.
   
• By consenting to teletherapy for a minor, the parent/guardian accepts full responsibility for supervision, compliance with therapy recommendations, and ensuring the child’s safe participation.
   

• Teletherapy has been demonstrated by research to be a highly effective and appropriate modality for treating Orofacial Myofunctional Disorders.
   
• Clients acknowledge that while outcomes are often positive, results cannot be guaranteed and depend on client compliance, participation, and practice between sessions.
   

By signing this agreement, you authorize Myofunctional Spot and Dena Freedman-Muchnick (including any affiliated providers) to use oral photographs, videos, or recordings as follows:

• Clinical Use (HIPAA-Protected): Oral photographs, facial images, or videos may be taken as part of evaluation and treatment. These records are considered part of your HIPAA-protected medical record and may be used internally for clinical documentation, measuring progress, and treatment planning. Such media may also be shared with parties specifically authorized under a signed HIPAA Authorization for Release of Information.
   
• Educational & Professional Use (De-Identified): De-identified oral photographs/videos may be used at the clinician’s discretion for educational, scientific, and professional purposes, including but not limited to professional lectures, publications, brochures, and website content.
   
• Confidentiality: All personal identifiers (e.g., name, address, contact information) will be removed, with the exception of general descriptors such as age and sex if clinically relevant.
   

Clients acknowledge that media documentation is an important clinical tool and agree to the above limited uses under HIPAA compliance standards.

• Clients are advised that email and text messaging are not fully HIPAA-secure methods of communication. Risks include but are not limited to: unauthorized access, interception, misdelivery, or technical failures.
   
• Myofunctional Spot will use reasonable and industry-standard safeguards to protect Protected Health Information (PHI) but cannot guarantee absolute confidentiality when email or text is used.
   

• By consenting to communicate via email or text, clients acknowledge that:
  
  
  • They are aware of the risks associated with these non-secure forms of communication.
     
  • They authorize Myofunctional Spot and its providers to use email and text for scheduling, appointment reminders, and health-related updates, knowing that absolute HIPAA-level confidentiality cannot be guaranteed.
     
  • They accept full responsibility for monitoring their own device security (e.g., protecting devices, avoiding shared accounts, maintaining privacy).
     
• Myofunctional Spot and its providers are not liable for breaches of confidentiality, miscommunication, delays, or disclosures arising from the use of email or text messaging.
   

By participating in teletherapy, consenting to media use, and agreeing to communicate electronically, you confirm that you:

• Have read and understood the above policies.
   
• Accept and acknowledge the limitations of teletherapy, electronic communications, and HIPAA protections.
   
• Understand that if the client is a minor, parental/guardian consent, participation, and supervision are required for all teletherapy services.
   
• Assume full responsibility for technology use, communication risks, and decisions regarding consent.
   
• Release Myofunctional Spot and its providers from liability related to technical failures, unauthorized access, or security breaches beyond their reasonable control.
   

As part of our programs, clients are recommended to purchase a Myofunctional Enrollment Box containing therapy tools, supplies, and resources recommended by our clinicians. These tools are carefully selected based on our clinical judgment, training, and experience in the field of orofacial myofunctional therapy. The following policies apply:

• The tools provided are intended to support therapy goals and to be used as part of your individualized therapy program.
   
• We provide tools that we believe may benefit the child, based on our experience and evolving best practices in the field.
   
• Orofacial myofunctional therapy is a constantly evolving discipline. While we make every effort to stay aligned with evidence-based practice, tools and techniques may shift as research and recommendations develop.
   
• The use of tools and exercises provided does not guarantee any specific outcome or result. Progress depends on many factors, including but not limited to: consistency of use, adherence to recommendations, individual differences in anatomy and physiology, and collaboration of the parent/guardian as part of the therapy process.
   

• At times, we may provide tools or supplies that are not specifically within the manufacturer’s recommended age range. This does not constitute a prescription or directive to use the tool. These are suggestions based on our experience.
   
• It is the parent/guardian’s sole responsibility to research each item provided, review manufacturer guidelines, and determine whether or not it is appropriate to use with their individual child.
   
• Parents/guardians acknowledge that they may receive tools outside the manufacturer’s recommended age range. By choosing to use such tools, they confirm that they have reviewed manufacturer guidance, conducted their own due diligence, and accept full responsibility for that decision.
   
• Any decision to use such tools with a child outside of manufacturer recommendations is made entirely at the parent/guardian’s discretion and risk.
   

• The tools provided in the Enrollment Box are not medical devices, and no item included should be interpreted as medical advice, prescription, or a directive to treat a medical condition.
   
• Parents/guardians must consult their child’s physician, dentist, or healthcare provider before using any therapy tool if there are concerns about safety, appropriateness, or age restrictions.
   

• Tools provided in the Enrollment Box are intended to be introduced and demonstrated within therapy sessions (typically 30 minutes weekly) under direct clinician supervision.
   
• Use outside of scheduled therapy sessions is done at the sole discretion and responsibility of the parent/guardian.
   
• By accepting and using the Enrollment Box, you assume full responsibility for the safe and appropriate use of all tools and supplies provided.
   
• Myofunctional Spot, its providers, and affiliates are not liable for any injury, adverse reaction, or undesired outcome related to the use of tools or supplies, whether used according to or outside of manufacturer recommendations.
   

• Enrollment Boxes and included tools are non-refundable under all circumstances.
   
• The cost of these tools is part of the overall therapy program. Refunds will not be provided for dissatisfaction with or decisions not to use specific tools.
   
• By accepting and retaining your Enrollment Box, you acknowledge and agree to use the contents at your own discretion and responsibility.
   

• Myofunctional therapy is a collaborative treatment model. The parent/guardian is considered an essential member of the therapy team.
   
• We provide training, education, and guidance on how to safely and effectively use tools based on our knowledge and clinical experience.
   
• Ultimately, the parent/guardian’s role in following through with therapy and in monitoring the child’s safe use of tools is critical to the success of the program.
   

By enrolling in our program, receiving a Myofunctional Enrollment Box, and/or using the tools provided, you acknowledge and accept these terms in full. You understand that all tools are provided as therapeutic aids to be used at your discretion and responsibility, and that Myofunctional Spot and its providers cannot be held liable for their use outside of supervised therapy sessions or outside manufacturer recommendations.

If you are a minor, your parent(s) or legal guardian(s) may be legally entitled to certain information about your treatment. I will use professional judgment to determine what information is appropriate to share with your parent(s)/guardian(s) and what information is more appropriately kept confidential to protect the integrity of therapy. Parents/guardians acknowledge that some degree of confidentiality between a minor and clinician is necessary for effective treatment.

Ending therapeutic relationships can be difficult, but a structured termination process is important for closure. The appropriate length of termination depends on the length and intensity of treatment.

• I may terminate treatment after appropriate discussion and a termination process if:
   
  • Treatment is not being effectively used or attended.
     
  • You are in default on payment.
     
• I will not terminate the therapeutic relationship without first discussing the reasons for termination and the purpose of concluding treatment.
   
• If treatment is terminated for any reason, or you request another provider, I will make a best effort to provide you with referrals to qualified speech-language pathologists and/or myofunctional therapists. You may also choose your own provider from another referral source.
   
• Refunds will not be provided in the event of termination.
   
• If you fail to schedule or attend an appointment for three consecutive weeks (unless other arrangements have been made in advance), I am ethically and legally obligated to consider the professional relationship discontinued.

• For any reason in which I, or any member of my clinical team, determine that the therapeutic relationship is not an appropriate clinical fit or that there is a lack of alignment in treatment goals or expectations.
   

Some therapy services may require the collection of medical records. These may include:

• X-rays
   
• Photographs and videos
   
• Written medical or dental records
   

These records will be used by Dena Freedman-Muchnick, M.S., CCC-SLP, and the Myofunctional Spot team solely for the purpose of evaluating oral motor musculature, airway, and associated function, and for clinical documentation required under the Health Insurance Portability and Accountability Act (HIPAA).

All records will be stored securely in compliance with HIPAA and will not be released without your written consent, except as required by law.

By continuing with treatment, I acknowledge that I have read and fully understand the details of therapy as described above. I agree to participate in treatment at my own risk and accept full responsibility for compliance with therapy recommendations. I further acknowledge and accept the following:

• I understand the limits of confidentiality and consent to the sharing of treatment information with my parent(s)/guardian(s) when legally or clinically appropriate (if I am a minor).
   
• I understand that therapy may be terminated in accordance with the policy above, and that refunds will not be issued.
   
• I understand that medical records and images collected during therapy are part of my HIPAA-protected medical record and will be used solely for clinical purposes.

At Myofunctional Spot, our goal is to support you in achieving the best possible outcomes through individualized care, education, and guidance. Myofunctional therapy is a collaborative process: your therapist provides expertise, structure, and tools, while you (or your child) play a key role in following through with the exercises and strategies at home. Together, this partnership can make a powerful difference.

Because myofunctional therapy requires both professional guidance and consistent at-home practice, results will always depend on your level of commitment and follow-through. We recommend practicing exercises for at least five minutes, 5–6 times per day. Some activities can be done passively (such as while driving or watching TV), while others require focused practice in front of a mirror or with the specific tools provided in your therapy enrollment kit.

We know there is a lot of information circulating on social media and the internet about myofunctional therapy. Just as you wouldn’t attempt to self-treat after surgery using generic physical therapy exercises, it’s important not to rely on unsupervised or unverified advice. Doing so may interfere with or even reverse your progress. The best outcomes come from following your individualized program created and guided by a licensed speech-language pathologist and/or myofunctional therapist.

Our commitment is to invest significant time and expertise into every client’s treatment plan. Your commitment is to follow through with the program consistently. If you choose to pause therapy, you are always welcome to return at a later date; however, refunds will not be issued. In rare and exceptional circumstances, credits may be offered at the sole discretion of the clinician.

No Guarantee of Outcomes

While research strongly supports the benefits of myofunctional therapy, every individual is unique. Results depend on many factors, including anatomy, medical history, compliance, and other circumstances beyond our control. For this reason, no specific outcomes can be promised or guaranteed.

Shared Responsibility

By enrolling in this program, you acknowledge that your participation, practice, and follow-through are critical to progress. Lack of results related to missed practice or incomplete follow-through is solely the responsibility of the client/parent/guardian.

Medical & Structural Limitations

Some conditions (such as enlarged tonsils, untreated sleep apnea, an unreleased tongue-tie, allergies, or neurological issues) may limit progress even when therapy is followed faithfully. In such cases, we may recommend additional referrals. These factors are outside our scope of control and do not constitute grounds for a refund.

Financial Policy

Because each program involves substantial clinician time, expertise, and preparation, all payments are final. Refunds will not be issued for dissatisfaction with results, inconsistent participation, or discontinuation of treatment by the client.

Risks and Limitations of Therapy

As with any therapeutic intervention, there are inherent limitations and minimal risks involved in myofunctional therapy. While outcomes are often highly positive, progress varies depending on individual anatomy, medical history, compliance, and other factors outside the clinician’s control. Even when therapy is effective, results may take time to become apparent, and relapse may occur if new habits are not maintained. By enrolling in this program, you acknowledge and accept these risks and limitations as part of the therapeutic process.

Release of Liability

By participating in therapy, you agree to hold Myofunctional Spot and its providers harmless for outcomes that do not meet personal expectations, provided that therapy is delivered in accordance with professional standards of care.

Governing Law, Venue & Severability

These Policies & Procedures, all consents, and all services provided by Myofunctional Spot are governed by the laws of the State of Florida. Any dispute shall be brought exclusively in the state or federal courts located in Broward County, Florida. If any provision is found unenforceable, the remaining provisions remain in full force and effect.

Dispute Resolution; No Chargebacks

Client agrees to notify Myofunctional Spot in writing of any dispute within 10 days of the event giving rise to the dispute and to allow 30 days for resolution before initiating any action. Client agrees not to initiate credit card or ACH chargebacks for services rendered or for time/materials already invested; disputes will follow the process above. Unauthorized chargebacks constitute breach and may result in collections.

Attorney’s Fees and Collections

In any action to collect unpaid balances or enforce these policies, the prevailing party is entitled to recover reasonable attorney’s fees, court costs, collection fees, and interest. Overdue balances may incur a 1.5% monthly late fee (18% APR) where permitted by law.

Financial Authorization (Card on File)

Client/parent/guardian authorizes Myofunctional Spot to securely store a payment method and to automatically charge session fees, enrollment kits, late-cancel/no-show fees, tools/materials, and outstanding balances. Services may be paused or terminated for non-payment.

Scope of Practice & Medical Disclaimer

Services provided by Myofunctional Spot constitute speech-language pathology and/or educational coaching as applicable. We do not diagnose medical conditions, prescribe medications/devices, or replace care from a physician, dentist, or other licensed medical professional. Clients are advised to consult appropriate medical providers as needed.

Safety, Contraindications & Stop-Use Rule

Client/parent/guardian agrees to immediately discontinue any exercise or tool that causes pain, bleeding, dizziness, shortness of breath, or other adverse symptoms and to contact the clinician before resuming. In a medical emergency, call 911. Client is responsible for disclosing relevant medical history and promptly updating any changes.

Custody, Consent & Indemnification (Minors)

By authorizing treatment, the undersigned represents they have legal authority to consent for the minor and accept financial responsibility. In cases of joint custody or court orders, the undersigned agrees to provide documentation upon request and to indemnify and hold harmless Myofunctional Spot from disputes between parents/guardians regarding consent, payment, or access to records.

Recording, Intellectual Property & Materials License

Client may not record audio or video of sessions without prior written consent. All materials (including videos, handouts, plans, and exercise programs) are proprietary to Myofunctional Spot. A limited, non-exclusive, non-transferable, revocable license is granted for the client’s personal use only. Copying, distributing, publishing, reselling, or sharing with third parties is prohibited.

Data Privacy, Record Retention & Authorization to Exchange Information

Clinical records (including photos/videos) are maintained pursuant to HIPAA and applicable Florida record-retention requirements and may be securely archived after case closure. With a signed HIPAA Authorization, Myofunctional Spot may exchange pertinent information with designated members of the client’s healthcare team to coordinate treatment.

Electronic Communications Boundaries

Email and text are used primarily for administrative matters (scheduling, logistics). Urgent or emergency issues are not managed by email or text. Responses are provided during business hours and are not guaranteed outside those hours. Clients acknowledge the inherent risks of electronic communication and agree to the Electronic Communication Policy.

Force Majeure

Services may be rescheduled, modified, or delivered via telehealth if affected by events beyond provider control (including natural disasters, pandemics, government actions, utility/technology outages, or other emergencies). No refunds apply; reasonable alternatives will be offered at provider discretion.

Modifications in Writing; Entire Agreement; Electronic Signatures

Policies may be updated prospectively; the current version at the time of service applies. No verbal modification is valid; changes must be in writing and signed by Myofunctional Spot. These Policies & Procedures (and incorporated forms/consents) constitute the entire agreement between the parties regarding the subject matter. Electronic signatures are legally binding and enforceable.