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Kentucky

Counselors

Counselors

Source

“Legislative Research Commission PDF Version Page: 1 201 KAR 36:045. Distance counseling. RELATES TO: KRS 335.505, 335.515(1), (3), (11) STATUTORY AUTHORITY: KRS 335.515(3), (11) NECESSITY, FUNCTION, AND CONFORMITY: KRS 335.515(3) requires the board to promulgate administrative regulations necessary to carry out and enforce the provisions of KRS 335.500 to 335.599. This administrative regulation establishes procedures for preventing abuse and fraud through the use of distance counseling, prevents fee-splitting through the use of distance counseling, and utilizes distance counseling in the provision of professional counseling services and in the provision of continuing education.

Section 1. Client Requirements. A licensee using distance counseling to deliver counseling services or who practices distance counseling shall, upon initial contact with the client:

(1) Make attempts to verify the identity of the client;

(2) Obtain alternative means of contacting the client other than electronically such as by the use of a telephone number or mailing address;

(3) Provide to the client alternative means of contacting the licensee other than electronically such as by the use of a telephone number or mailing address;

(4) Provide contact methods of alternative communication the licensee shall use for emergency purposes such as an emergency on call telephone number; and

(5) Document if the client has the necessary knowledge and skills to benefit from the type of distance counseling provided by the licensee;

(6) Document which services were provided by distance counseling;

(7) Use secure communications with clients, including encrypted text messages via e-mail or secure Web sites, and not use personal identifying information in non-secure communications; and

(8) Inform the client in writing about:

(a) The limitations of using technology in the provision of distance counseling;

(b) Potential risks to confidentiality of information due to technology in the provision of distance counseling;

(c) Potential risks of disruption in the use of distance counseling;

(d) When and how the licensee will respond to routine electronic messages;

(e) In what circumstances the licensee will use alternative communications for emergency purposes;

(f) Who else may have access to client communications with the licensee;

(g) How communications can be directed to a specific licensee;

(h) How the licensee stores electronic communications from the client;

(i) Whether the licensee or client may elect to discontinue the provision of services through distance counseling; and

(j) The reporting of clients required by 201 KAR 36:040,

Sections 2 and 3.

Section 2. Competence, Limits on Practice, Maintenance, and Retention of Records.

A licensee using distance counseling to deliver counseling services or who practices distance counseling shall:

(1) Limit the practice of distance counseling to the area of competence in which proficiency has been gained through education, training, and experience;

(2) Maintain current competency in the practice of distance counseling through continuing education, consultation, or other procedures, in conformance with current standards of scien- Legislative Research Commission PDF Version Page: 2 tific and professional knowledge;

(3) Document the client's presenting problem, purpose, or diagnosis;

(4) Maintain records in accordance with the requirements of 201 KAR 36:040; and

(5) Ensure that confidential communications obtained and stored electronically cannot be recovered and accessed by unauthorized persons when the licensee disposes of electronic equipment and data.

Section 3. Compliance with Federal, State, and Local Law.

A licensee using distance counseling to deliver counseling services or who practices distance counseling shall:

(1) Comply with the state law where the licensee initiates the distance counseling;

(2) Be licensed to practice counseling where the client is domiciled; and

(3) Comply with Section 508 of the Rehabilitation Act, 29 U.S.C. 794(d), to make technology accessible to a client with disabilities.

Section 4. Representation of Services and Code of Conduct.

A licensee using distance counseling to deliver counseling services or who practices distance counseling shall:

(1) Not engage in false, misleading, or deceptive advertising of distance counseling;

(2) Comply with 201 KAR 36:040; and

(3) Not split fees.

Section 5. Utilization of Distance Counseling in the Provision of Continuing Education. Providers approved pursuant to 201 KAR 36:030 may utilize distance counseling in the provision of continuing education courses. (Ky.R. 837, 1540; eff. 3-31-2017.)”

Social Workers

Social Workers

Source

“335.158 Duty of treating clinical social worker utilizing telehealth to ensure patient's informed consent and maintain confidentiality -- Board to promulgate administrative regulations -- Definition of "telehealth".

(1) A treating clinical social worker who provides or facilitates the use of telehealth shall ensure:

(a) That the informed consent of the patient, or another appropriate person with authority to make the health care treatment decision for the patient, is obtained before services are provided through telehealth; and

(b) That the confidentiality of the patient's medical information is maintained as required by this chapter and other applicable law. At a minimum, confidentiality shall be maintained through appropriate processes, practices, and technology as designated by the board and that conform to applicable federal law.

(2) The board shall promulgate administrative regulations in accordance with KRS Chapter 13A to implement this section and as necessary to:

(a) Prevent abuse and fraud through the use of telehealth services;

(b) Prevent fee-splitting through the use of telehealth services; and

(c) Utilize telehealth in the provision of clinical social work services and in the provision of continuing education.

(3) For purposes of this section, "telehealth" means the use of interactive audio, video, or other electronic media to deliver health care. It includes the use of electronic media for diagnosis, consultation, treatment, transfer of health or medical data, and continuing education. Effective: July 14, 2000 History: Created 2000 Ky. Acts ch. 376, sec. 20, effective July 14, 2000.”

Marriage and Family Therapists

Source

 “Legislative Research Commission PDF Version Page: 1 201 KAR 32:110. Telehealth. RELATES TO: KRS 335.300, 335.305, 335.310, 335.320, 335.325, 335.332, 335.380, 335.399 STATUTORY AUTHORITY: KRS 335.320(9), 335.380 NECESSITY, FUNCTION, AND CONFORMITY: KRS 335.320(9) requires the Board of Licensure for Marriage and Family Therapists to promulgate administrative regulations to implement the purpose and scope of KRS 335.300 to 335.399. KRS 335.380 requires the board to promulgate administrative regulations to govern telehealth services in the provision of marriage and family therapy services. This administrative regulation establishes procedures for the use of telehealth by licensees and associates

Section 1. Definitions.

(1) "Asynchronous" means a communication that does not occur simultaneously in real time.

(2) "Electronic communication" means the use of Web sites, cell phones, email, texting, online social networking, video, or other digital methods and technology used to send and receive messages or post information. (3) "Encryption" means a mathematical process that converts text, video, or audio streams into a scrambled, unreadable format when transmitted electronically.

(4) "Fee-splitting" means offering or accepting payment for referrals other than in an employer-employee or contractor-contractee relationship.

(5) "HIPAA" means the Health Insurance Portability and Accountability Act of 1996, Pub L. No. 104-191, 110 Stat. 1936 (1996).

(6) "HITECH" means the Health Information Technology for Economic and Clinical Health Act of 2009, 42 U.S.C. 17901-17953.

(7) "Social media" means a Web-based communication tool that enables people to interact with each other by both sharing and consuming information.

(8) "Synchronous" means a communication that occurs simultaneously in real time.

(9) "Telehealth" is defined by KRS 335.380(3).

Section 2. Licensure, Standard of Practice, and Competency.

(1) License or permit required. Each licensed marriage and family therapist, or permitted marriage and family therapy associate practicing telehealth in this state shall be licensed by the board, or hold a permit issued by the board, and comply with all statutes, administrative regulations, and ethics guidelines applicable to the practice of marriage and family therapy.

(2) Standard of appropriate practice. A licensed marriage and family therapist, or permitted marriage and family therapy associate providing telehealth services in this state shall be held to the same standards of practice as those applicable for in-person therapy settings.

(3) Competency. A licensed marriage and family therapist, or permitted marriage and family therapy associate shall only provide telehealth services in this state in those instances in which the licensed marriage and family therapist, or permitted marriage and family therapy associate has successfully completed all requirements set forth in Section 3(1) of this administrative regulation.

(4) Continued competency. A licensed marriage and family therapist, or permitted marriage and family therapy associate providing telehealth services in this state shall have an ongoing obligation to assess his or her technical and clinical competency to render these services by successfully completing all requirements set forth in Section 3(2) of this administrative regulation.

(5) Fee splitting. A licensed marriage and family therapist, or permitted marriage and family Legislative Research Commission PDF Version Page: 2 therapy associate providing telehealth services shall not split fees.

Section 3. Education and Continuing Education Requirements.

(1) Initial educational requirements. Effective January 1, 2020, a licensed marriage and family therapist, or a permitted marriage and family therapy associate providing telehealth services in this state, and a licensed marriage and family therapist who is supervising a marriage and family therapy associate providing telehealth services in this state shall have completed fifteen (15) hours of board-approved training in the practice of telehealth as provided in 201 KAR 32:060, Section 2(2), which shall include three (3) hours of ethics in the practice of telehealth. Each approved course shall be live or online.

Areas to be covered in the training shall include:

(a) Appropriateness of teletherapy;

(b) Teletherapy theory and practice;

(c) Modes of delivery;

(d) Legal and ethical issues;

(e) Handling online emergencies; and

(f) Best practices and informed consent.

(2) Continuing education requirements. A licensed marriage and family therapist, or permitted marriage and family therapy associate who has completed the initial training in the practice of telehealth shall complete at least two (2) credit hours of continuing education approved by the board, in accordance with 201 KAR 32:060, in the practice of telehealth during each subsequent renewal period.

(3) Credit hours earned to comply with subsections (1) and (2) of this Section may be applied to continuing education requirements set forth in 201 KAR 32:060.

Section 4. Verification of the Client. Prior to providing initial telehealth services in this state a licensed marriage and family therapist, or permitted marriage and family therapy associate shall require the client to produce a valid photo identification. If the client is a minor, prior to providing telehealth services in this state a licensed marriage and family therapist, or permitted marriage and family therapy associate shall verify the identity of the parent, guardian, or other person consenting to the minor’s treatment.

Section 5. Client Assessment. (1) Initial assessment. Prior to providing telehealth services in this state a licensed marriage and family therapist, or permitted marriage and family therapy associate shall conduct an initial assessment of the client to determine if telehealth is an appropriate delivery of treatment considering the professional, intellectual, or emotional needs of the client.

(2) Ongoing assessment. Throughout the duration of providing telehealth services in this state, a licensed marriage and family therapist, or permitted marriage and family therapy associate shall engage in a continual assessment of the appropriateness of providing these services to the client.

(3) Telehealth may not be appropriate if the client: (a) Recurrently experiences, or is likely to experience, crises or emergencies; (b) Is a suicide risk, or likely to become a suicide risk; (c) Is violent, or likely to become violent; or (d) Otherwise poses a risk to themselves or to others.

Section 6. Informed Consent. (1) Generally. Prior to providing telehealth services in this state, the licensed marriage and family therapist, or permitted marriage and family therapy asociate providing these services shall obtain the informed consent of the client, which shall include:

(a) Disclosure of specific information regarding the licensed marriage and family therapist's, or permitted marriage and family therapy associate’s:

1. Training and credentials;

2. License or permit number;

3. Physical location and contact information;

4. Social media policy;

5. Encryption policy; and

6. Collection, documentation, tracking, and storage of client information;

(b) Client confidentiality and the limits to confidentiality in electronic communication;

(c) Information on reporting complaints to the board and other appropriate licensing bodies;

(d) The specific services to be provided;

(e) The risks and benefits of engaging in telehealth in the clinical setting;

(f) The possibility of technology failure and alternate methods of service delivery;

(g) Time zone differences, if any;

(h) Cultural or language differences that may affect the delivery of services;

(i) The possible denial of insurance benefits;

(j) The pertinent legal rights and limitations governing practice across state lines or international boundaries, if applicable; and

(k) Whether delivery of service will be asynchronous or synchronous.

(2) Minors. Except as allowed by KRS 214.185, if the client is a minor, prior to providing telehealth services in this state the licensed marriage and family therapist, or permitted marriage and family therapy associate shall, pursuant to Section 4 of this administrative regulation, verify the identity of the parent, guardian, or other person consenting to the minor's treatment and obtain from that person the informed consent required by this section.

Section 7. Emergency Procedures, Coordination of Care and Referrals. Prior to providing telehealth services in this state, the licensed marriage and family therapist, or permitted marriage and family therapy associate shall establish with the client:

(1) Acceptable ways to contact the licensed marriage and family therapist, or permitted marriage and family therapy associate in an emergency;

(2) Emergency procedures to include emergency services at the client's location;

(3) Coordination of care with other professionals; and

(4) Conditions under which telehealth services may be terminated and a referral made to inperson care.

Section 8. Compliance with Privacy Laws, Documentation, and Recordkeeping. A licensed marriage and family therapist, or permitted marriage and family therapy associate performing telehealth services in this state shall:

(1) Comply with all privacy laws and regulations relating to the transmission and protection of protected health information, including HIPAA and HITECH; and (2) Comply with all state and federal laws and regulations relating to the practice of telehealth, documentation of services delivered, and related recordkeeping. (45 Ky.R. 1855, 27005; eff. 5-3-2019; 47 Ky.R. 548, 707; eff. 10-28-2020.)”

Psychologists

Source

201 KAR 26:310. Telehealth and telepsychology

Section 1. Definitions. 

     "(1) "Client" is defined by 201 KAR 26:145, Section 2;

      (2) "Telehealth" is defined by KRS 319.140(3);

      (3) "Telepsychology" means "practice of psychology" as defined by KRS 319.010(7) between the psychologist and the patient:

      (a) Provided using an electronic communication technology; or

      (b) Two (2) way, interactive, simultaneous audio and video." 

    "Section 2. Client Requirements. A credential holder using telehealth to deliver psychological services or who practices telepsychology shall, upon initial contact with the client:

      (1) Make reasonable attempts to verify the identity of the client;

      (2) Obtain alternative means of contacting the client other than electronically;

      (3) Provide to the client alternative means of contacting the credential holder other than electronically;

      (4) Document if the client has the necessary knowledge and skills to benefit from the type of telepsychology provided by the credential holder;

      (5) Use secure communications with clients, including encrypted text messages via e-mail or secure Web sites, and not use personal identifying information in non-secure communications;

      (6) Inform the client in writing about:

      (a) The limitations of using technology in the provision of telepsychology;

      (b) Potential risks to confidentiality of information due to technology in the provision of telepsychology;

      (c) Potential risks of disruption in the use of telepsychology;

      (d) When and how the credential holder will respond to routine electronic messages;

      (e) In what circumstances the credential holder will use alternative communications for emergency purposes;

      (f) Who else may have access to client communications with the credential holder;

      (g) How communications can be directed to a specific credential holder;

      (h) How the credential holder stores electronic communications from the client; and

      (i) The reporting of clients required by 201 KAR 26:145, Section 7." 

     " Section 3. Competence, Limits on Practice, Maintenance, and Retention of Records. A credential holder using telehealth to deliver psychological services or who practices telepsychology shall:

      (1) Limit the practice of telepsychology to the area of competence in which proficiency has been gained through education, training, and experience;

      (2) Maintain current competency in the practice of telepsychology through continuing education, consultation, or other procedures, in conformance with current standards of scientific and professional knowledge;

      (3) Document the client’s presenting problem, purpose, or diagnosis;

      (4) Follow the record-keeping requirements of 201 KAR 26:145, Section 6; and

      (5) Ensure that confidential communications obtained and stored electronically cannot be recovered and accessed by unauthorized persons when the credential holder disposes of electronic equipment and data." 

      "Section 4. Compliance with Federal, State, and Local Law. A credential holder using telehealth to deliver psychological services or who practices telepsychology shall comply with:

      (1) State law where the credential holder is credentialed and be licensed to practice psychology where the client is domiciled; and

      (2) Section 508 of the Rehabilitation Act, 29 U.S.C. 794(d), to make technology accessible to a client with disabilities;" 

      "Section 5. Representation of Services and Code of Conduct. A credential holder using telehealth to deliver psychological services or who practices telepsychology:

      (1) Shall not by or on behalf of the credential holder engage in false, misleading, or deceptive advertising of telepsychology;

      (2) Shall comply with 201 KAR 26:145. (37 Ky.R. 1597; Am. 1987; eff. 3-4-2011.)"

Refer to the source provided for all requirements and limitations.

Psychiatrists

Source

Source: 201 KAR 36:045. Distance counseling

RELATES TO: KRS 335.505, 335.515(1), (3), (11)

STATUTORY AUTHORITY: KRS 335.515(3), (11)

“NECESSITY, FUNCTION, AND CONFORMITY: KRS 335.515(3) requires the board to promulgate administrative regulations necessary to carry out and enforce the provisions of KRS 335.500 to 335.599. This administrative regulation establishes procedures for preventing abuse and fraud through the use of distance counseling, prevents fee-splitting through the use of distance counseling, and utilizes distance counseling in the provision of professional counseling services and in the provision of continuing education.”

“Section 1. Client Requirements. A licensee using distance counseling to deliver counseling services or who practices distance counseling shall, upon initial contact with the client:

(1) Make attempts to verify the identity of the client;

(2) Obtain alternative means of contacting the client other than electronically such as by the use of a telephone number or mailing address;

(3) Provide to the client alternative means of contacting the licensee other than electronically such as by the use of a telephone number or mailing address;

(4) Provide contact methods of alternative communication the licensee shall use for emergency purposes such as an emergency on-call telephone number; and

(5) Document if the client has the necessary knowledge and skills to benefit from the type of distance counseling provided by the licensee;

(6) Document which services were provided by distance counseling;

(7) Use secure communications with clients, including encrypted text messages via e-mail or secure Web sites, and not use personal identifying information in non-secure communications; and

(8) Inform the client in writing about:

(a) The limitations of using technology in the provision of distance counseling;

(b) Potential risks to the confidentiality of information due to technology in the provision of distance counseling;

(c) Potential risks of disruption in the use of distance counseling;

(d) When and how the licensee will respond to routine electronic messages;

(e) In what circumstances the licensee will use alternative communications for emergency purposes;

(f) Who else may have access to client communications with the licensee;

(g) How communications can be directed to a specific licensee;

(h) How the licensee stores electronic communications from the client;

(i) Whether the licensee or client may elect to discontinue the provision of services through distance counseling; and

(j) The reporting of clients required by 201 KAR 36:040, Sections 2 and 3.”

“Section 2. Competence, Limits on Practice, Maintenance, and Retention of Records. A licensee using distance counseling to deliver counseling services or who practices distance counseling shall:

(1) Limit the practice of distance counseling to the area of competence in which proficiency has been gained through education, training, and experience;

(2) Maintain current competency in the practice of distance counseling through continuing education, consultation, or other procedures, in conformance with current standards of scientific and professional knowledge;

(3) Document the client's presenting problem, purpose, or diagnosis;

(4) Maintain records in accordance with the requirements of 201 KAR 36:040; and

(5) Ensure that confidential communications obtained and stored electronically cannot be recovered and accessed by unauthorized persons when the licensee disposes of electronic equipment and data.”

“Section 3. Compliance with Federal, State, and Local Law. A licensee using distance counseling to deliver counseling services or who practices distance counseling shall:

(1) Comply with the state law where the licensee initiates the distance counseling;

(2) Be licensed to practice counseling where the client is domiciled; and

(3) Comply with Section 508 of the Rehabilitation Act, 29 U.S.C. 794(d), to make technology accessible to a client with disabilities.”

“Section 4. Representation of Services and Code of Conduct. A licensee using distance counseling to deliver counseling services or who practices distance counseling shall:

(1) Not engage in false, misleading, or deceptive advertising of distance counseling;

(2) Comply with 201 KAR 36:040; and

(3) Not split fees.”

“Section 5. Utilization of Distance Counseling in the Provision of Continuing Education. Providers approved pursuant to 201 KAR 36:030 may utilize distance counseling in the provision of continuing education courses. (Ky.R. 837, 1540; eff. 3-31-2017.)”

Refer to the source provided for all requirements and limitations.

Kentucky Professional Regulations/Health & Safety Online Prescribing

Source

(e) “In response to any communication transmitted or received by computer or other electronic means, when the licensee fails to take the following actions to establish and maintain a proper physician-patient relationship: 

1. Verification that the person requesting medication is in fact who the patient claims to be;

 2. Establishment of a documented diagnosis through the use of accepted medical practices; and 

3. Maintenance of a current medical record. For the purposes of this paragraph, an electronic, on-line, or telephonic evaluation by questionnaire is inadequate for the initial evaluation of the patient or for any follow-up evaluation.”

“For the purposes of this paragraph, an electronic, on-line, or telephonic evaluation by questionnaire is inadequate for the initial evaluation of the patient or for any follow-up evaluation.”

Refer to the source provided for all requirements and limitations.

Nurses

“As a party state to the Nurse Licensure Compact (NLC), Kentucky issues multistate licenses to nurses and applicants who reside in the state and recognizes multistate licenses issued by other party states, for practice in Kentucky. A nurse holding a multistate license is entitled to practice in any NLC party state, but must comply at all times with the laws of the state where he or she is currently practicing.”

“It should be noted that not every state in the US is an NLC party state; a map of participating states, as well as further resources related to the NLC, are available on the Nurse Licensure Compact website.”

Refer to the source provided for all requirements and limitations.

Kentucky Professional Regulations/Health & Safety Online Prescribing

Source

(e) “In response to any communication transmitted or received by computer or other electronic means, when the licensee fails to take the following actions to establish and maintain a proper physician-patient relationship: 

1. Verification that the person requesting medication is in fact who the patient claims to be;

 2. Establishment of a documented diagnosis through the use of accepted medical practices; and 

3. Maintenance of a current medical record. For the purposes of this paragraph, an electronic, on-line, or telephonic evaluation by questionnaire is inadequate for the initial evaluation of the patient or for any follow-up evaluation.”

“For the purposes of this paragraph, an electronic, on-line, or telephonic evaluation by questionnaire is inadequate for the initial evaluation of the patient or for any follow-up evaluation.”

Refer to the source provided for all requirements and limitations.

Medicaid Telehealth Parity Law

Source: KY Revised Statutes. 205.5591 (Accessed 11/2019)

“(5) The Medicaid program or a Medicaid managed care organization shall reimburse for covered services provided to a Medicaid recipient through telehealth, as defined in KRS 205.510. The department shall promulgate administrative regulations to establish requirements for telehealth coverage and reimbursement, which shall be equivalent to the coverage for the same service provided in person unless the telehealth provider and the Medicaid program or a Medicaid managed care organization contractually agree to a lower reimbursement rate for telehealth services, or the department establishes a different reimbursement rate.”

No Medicaid Reimbursement for telephone.

Refer to the source provided for all requirements and limitations.

Originating Site Reimbursement: The place of service is anywhere the patient is located at the time the telehealth service is provided, including home, clinic, office, school, workplace. (KY Admin. Regs. Title, 907, 3:170)

Private Pay Telehealth Parity Law

Source: KY Revised Statutes § 304.17A-138

“(1) (a) A health benefit plan shall reimburse for covered services provided to an insured person through telehealth as defined in KRS 304.17A-005. Telehealth coverage and reimbursement shall be equivalent to the coverage for the same service provided in person unless the telehealth provider and the health benefit plan contractually agree to a lower reimbursement rate for telehealth services.

(4) Nothing in this section shall be construed to require a health benefit plan to:

(a) Provide coverage for telehealth services that are not medically necessary”

Refer to the source provided for all requirements and limitations.

Payment Parity

Source: KY Revised Statutes § 304.17A-138

“(1) (a) A health benefit plan shall reimburse for covered services provided to an insured person through telehealth as defined in KRS 304.17A-005. Telehealth coverage and reimbursement shall be equivalent to the coverage for the same service provided in person unless the telehealth provider and the health benefit plan contractually agree to a lower reimbursement rate for telehealth services.”

Refer to the source provided for all requirements and limitations.

Permission for the Temporary Practice of Clinicians Licensed Outside the State

We are not aware of any permission that allows for services delivered by out-of-state providers. 

Note: As this is a free resource and Rules and Regulations regarding Telehealth are always changing, we appreciate any updates or corrections. They can be emailed to us at This email address is being protected from spambots. You need JavaScript enabled to view it. with a link to the source or a citation of the rule or regulation.

THTC Program Button

Telemental health is not a separate service from mental health services. All state licensing boards require that licensed clinicians follow all the regulations for practicing under their license no matter what medium of communication is used. All licensing boards also require that clinicians only practice within the boundaries of their competence. This usually requires education, continuing education, and/or supervision in telemental health. Complete our telehealth training program to cover all the essential competencies of providing telemental health services and earn the THTC (Telemental Health Training Certificate).

1 comment

  • Comment Link Neha Mahboob Wednesday, 25 March 2020 14:11 posted by Neha Mahboob

    Hello Ma'am or Sir;
    I am a graduate student with the University of the Cumberlands and studying the accredited Master program Clinical Mental Health Counseling. I am in my last year-doing clinicals-and because of the Covid-19 pandemic, I was wondering if KY Board of Counseling Licensure allows students to practice telehealth as most sites are closed and my supervisor is doing telecounseling since face-to-face sessions are cancelled till further notice.

    Please let me know as soon as possible so I can inform my professor and, if yes, start working on the probono clients I have.

    Thank you and be safe.

    Neha Mahboob

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