Frequently asked questions.

Why are you called Steel & Flora?

Steel is a human-engineered material. We depend on its strength for amazing feats of modernity. The natural world brings us powerful methods of healing that existed before humans, or that evolved beside us. The idea of Steel & Flora is that these two don’t have to be at odds. We benefit from combining science and nature.

How do I know if I’m a good fit for this practice?

People who feel ready to do their part in achieving wellness will find a supportive space to be held when they stumble. Health care workers will find a place to receive the compassion they may not be getting at work. People who need care that respects the challenges inherent in any marginalized identity will be embraced. Any Steel & Flora Wellness contracted provider will be versed in trauma-informed care, body positivity, health equity, cultural humility, and evidence-based practice. (And the Oxford comma.)

People who want an informal communication style and direct feedback will also do well here. If you want to drop an f-bomb, this is a safe space.

Unfortunately as a telehealth service, it would not be safe to take on clients with high acuity. If you’ve been hospitalized or to an ER for mental health reasons within the last 5 years we won’t be best suited to provide your care. People also need to be independent in managing their health care.

Do I have to take medicine or herbs?

We will give recommendations based on our best clinical assessment. We will not judge how you want to care for your body, and we can’t very well follow you around putting medication or plants on your tongue. That said sometimes we may become concerned on an ongoing basis that lack of treatment puts someone at risk. In those cases, we may discuss transitioning care to a place more suited to keeping you safe.

How do I become a client?

Use the schedule button for a free consult (basically a meet and greet). We answer your questions, ask some of our own and both decide if we are a good fit. If so, we go over information about how the practice works and help you get scheduled.

Is this care confidential?

Yes. We follow federal privacy laws. Our electronic health record, Luminello, is HIPAA compliant. We have a BAA with Acuity Scheduling that is also HIPAA compliant. Spruce Health, which we use for phone, fax, and messaging is also secure.

What do I do with a mental health crisis?

If you feel unsafe in any way, go to the emergency room or call 911. If you have access to firearms, lock them up or separate them from their ammunition. The 24-hour National Suicide Prevention Lifeline is 800-273-8255. If you want to read what they have to say about the populations at highest risk for suicide, visit their website. Trans Lifeline can be reached at 877-565-8860.

For less dire situations, you can call us or send a Spruce message.

How can I communicate with you?

Message through the Spruce Health app or desktop page. You are always welcome to go nuts and use the telephone as well.

Do you take insurance?

Yes! Check the pricing page for the latest on what insurances we are contracted with. For out of network, we will give you superbills you can submit for reimbursement.

You can typically use your insurance for medications and labs regardless of whether we are in network. An FSA is likely to cover these visits as well.

What kind of payment do you accept?

Any major credit card. If you have privacy concerns about using a credit card please contact us.

What happens if I no show an appointment?

You can cancel or reschedule through your confirmation email up to 48 hours prior to your visit. After that, you will be charged a no show fee. Exceptions will be considered on a case by case basis (i.e. the sh*t happens policy.)

Do you see people in-person?

Not at this time.

What technology do I need to do telehealth?

Probably nothing more than what you are using to read this. Computer or phone both work. If you can use Zoom, you have what you need. You can use Doxy.me using your phone or desktop, without downloading an app. Learn more about them here.

Can you communicate with my other health care providers?

Yes. Care coordination is important. You will need a release of information on both ends. It’s worth knowing that a primary care provider can have a caseload of over 2,000 people. So if getting in touch takes a minute, it’s not because you’re not important or valuable. You are.

How often should I be seen?

That is variable. Often when we are first starting any kind of care it’s helpful to see people no later than a month, and sometimes in one week. As you feel stable and empowered in your new behaviors, every 3 months will suffice. It’s good to bookmark time together because if you start to feel bad again it’s hard to reach out and schedule.

In what states do you practice?

Only in the state of Washington.

What ages do you see?

18 and up. (Or an emancipated minor.)

Do you do therapy?

No. We seek to have a therapeutic relationship, but therapists train long and hard to do what they do. We won’t sell you short by claiming to have the same training.

Is herbal medicine evidence-based?

It depends. Some integrative treatments have been studied quite a bit and others are based on traditional experience. Sadly, not much funding exists for research on herbal medicine. Many uses of plants are also meant to invoke gentle and gradual changes, which are a challenge to study. To the extent that evidence exists, we take that into consideration. We have a high value on safety whether our knowledge comes from evidence or knowledge that has been passed down through generations.

Is Tiny Habits evidence-based?

Yes. The creator of the Tiny Habits, B.J. Fogg, is the head of the Behavior Design Lab at Stanford and regularly publishes on the subject. In addition, there is quite a bit of research in the world of non-human animals that supports positive reinforcement training.