Terms of Service
Statement of Understanding - Informed Consent for SAP Evaluation Services
Catalyst Counseling & Consulting PLLC
Brandon Tripp, LMHC, SUDP, MAC, NCC AP, SAP
Licensed Mental Health Counselor
US Dept. of Transportation Qualified and Trained
Substance Abuse Professional Services Provider
SAP EVALUATION: SUBSTANCE USE DISORDERS & CO-OCCURRING DISORDERS
for essential workers in safety-sensitive positions who are regulated by the
U.S. Department of Transportation (DOT)
As an employee in a Department of Transportation safety-sensitive position, under the jurisdiction of the Federal Motor Carrier Safety Administration (FMCSA), Federal Aviation Administration (FAA), United States Coast Guard (USCG), Federal Railroad Administration (FRA), Pipeline and Hazardous Materials Safety Administration (PHMSA), Federal Transit Administration (FTA), Designated Employer Representative (DER), Medical Review Officer or TCA (Third-Party Consortium), you have requested to have your substance use evaluated by a qualified Substance Abuse Professional (SAP), as a result of violating a drug and/or alcohol policy that is covered by the DOT regulations. I, as an SAP, am required to follow procedures mandated by the DOT. The role of the SAP includes:
- Evaluating the extent of your use of alcohol and other prohibited psychoactive and prescribed substances.
- Developing a treatment plan that includes the types of education/treatment/recovery supports that are appropriate, based on the SAP evaluation.
- Helping you gain access to recommended education/treatment/recovery supports.
- Monitoring your participation and compliance with the treatment plan.
- Recommending to the DER/FTA your completion of all goals set forth in the treatment plan and are ready to submit for the return-to-duty alcohol and/or other drug test.
- Recommending to the DER/FTA follow-up testing, which will be done after your return to duty to safety sensitive positions, which are in addition to the normal required random drug testing.
An SAP evaluation is not drug or alcohol treatment.
The SAP evaluation is a comprehensive biopsychosocial clinical emotional assessment to identify possible substance use disorders, co-occurring mental health disorders, to determine what types of education/treatment/recovery support you will need to correct problems associated with alcohol and/or substance use. SAP services are separate from the recommended treatment, education, or assessment services, and you will be responsible for receiving the recommended services from a treatment provider. SAP assessment and treatment recommendations for this violation, are in addition to (unless other arrangements have been made and agreed to by the SAP, i.e., use of EAP, employer-paid assistance, etc.) The fee for the professional treatment and/or educational classes, treatment monitoring, final recommendations), for this violation, are due in advance (unless other arrangements have been made and agreed to by the SAP, i.e., use of EAP, employer-paid assistance, etc.).
This SAP covers SAP services from the time that I begin the return to duty with respect to this DOT violation and treatment recommendation. If you have another DOT violation in the future, a new evaluation (and fee) will be required.
After the initial assessment is completed, the SAP will recommend which education/treatment/recovery support services will best assist you in achieving your recovery goals. Participation in those programs offered by the education/treatment/recovery support providers may not influence or change the SAP's treatment plan. All decisions regarding changing the treatment plan must come back to the SAP for the SAP's final evaluation and clearance for you to submit for return-to-duty testing. It is in your best interest to cooperate and participate with the recommendations the SAP has for you by coming back to the SAP for the SAP's final evaluation and clearance for you to submit for return-to-duty testing. It is in your best interest to cooperate and participate with the SAP's initiation, continuing in, or completing the treatment plan goals.
Confidentiality & Record Retention
All information shared during the SAP evaluation process is confidential and will only be disclosed as required by DOT regulations or with your written consent. Records will be maintained in accordance with federal and state regulations governing substance abuse treatment and DOT requirements.
Questions or Concerns?
If you have any questions about this Statement of Understanding or the SAP evaluation process, please contact us:
Phone: (425) 230-4099
Website: www.catalystcc.services
By proceeding with SAP evaluation services, you acknowledge that you have read, understood, and agree to the terms outlined in this Statement of Understanding - Informed Consent.
DOT Compliance: All SAP services are provided in full compliance with 49 CFR Part 40, Subpart O, and other applicable Department of Transportation regulations.
Professional Credentials: Brandon Tripp is a Licensed Mental Health Counselor (LMHC) and Substance Use Disorder Professional (SUDP) who has completed all training requirements to serve as a DOT-qualified Substance Abuse Professional.
Service Areas: We provide SAP evaluation services to DOT-regulated employees across all transportation sectors including trucking, aviation, maritime, railroad, pipeline, and transit.
Additional Terms and Policies
Scope of Services
DOT SAP Services, PLLC provides DOT-mandated substance abuse professional evaluations, treatment recommendations, follow-up evaluations, and return-to-duty services in accordance with 49 CFR Part 40 regulations.
Our services include:
- Initial SAP evaluation for DOT-regulated employees
- Treatment and education program recommendations
- Follow-up evaluation and return-to-duty assessment
- Follow-up testing plan development
- Consultation with employers and designated employer representatives
Appointment and Scheduling
Appointment Confirmation
All appointments must be scheduled in advance. You will receive a confirmation email with the date, time, and location of your evaluation.
Punctuality
Please arrive 10 minutes early to complete any necessary paperwork. Late arrivals may result in rescheduling.
Cancellation Policy
Cancellations must be made at least 24 hours in advance. Late cancellations or no-shows may be subject to a cancellation fee.
Payment Terms
Payment for services is due at the time of service unless other arrangements have been made in advance.
Accepted Payment Methods
We accept credit cards, debit cards, and Venmo.
Fee Schedule
All fees are due 24 hours prior to the time of service. Fees are subject to change with 30 days' notice.
Payment Plans
Payment plans are not currently available.
Client Responsibilities
As a client of DOT SAP Services, you are responsible for:
- Providing accurate and complete information during the evaluation process
- Following through with recommended treatment and education programs
- Providing proof of completion of recommended programs before follow-up evaluation
- Attending all scheduled appointments or providing adequate notice of cancellation
- Maintaining communication with our office regarding your progress
- Understanding that SAP recommendations are professional opinions based on evaluation findings
Limitations and Disclaimers
No Guarantee of Return to Duty
While we provide comprehensive evaluations and recommendations, DOT SAP Services cannot guarantee that completion of our evaluation process will result in return to duty. The final decision to return an employee to safety-sensitive functions rests with the employer.
Not a Treatment Provider
DOT SAP Services provides evaluation and recommendation services only. We do not provide substance abuse treatment, counseling, or education programs. Clients are responsible for completing recommended programs with qualified treatment providers.
Professional Relationship
The SAP-client relationship is professional and focused on DOT compliance. This is not a therapeutic relationship, and we do not provide ongoing counseling or mental health treatment.
Termination of Services
DOT SAP Services reserves the right to discontinue services under the following circumstances:
- Non-payment for services rendered
- Failure to attend scheduled appointments without proper notice
- Threatening or abusive behavior toward staff
- Providing false or misleading information during the evaluation process
- Any other circumstances that make it impossible to provide appropriate services
Agreement and Consent
By scheduling an appointment with DOT SAP Services, you acknowledge that you have read, understood, and agree to these Terms of Service. You will be asked to sign a formal consent form at your first appointment that includes these terms and additional information about your rights and responsibilities.
If you have any questions about these terms or need clarification on any aspect of our services, please contact us before scheduling your evaluation.
Ready to Schedule Your Evaluation?
Contact us today to learn more about our services and begin the DOT SAP evaluation process.