Common use of MINORS & PARENTS Clause in Contracts

MINORS & PARENTS. Individuals over the age of eighteen have the right to independently consent to and receive mental health treatment without parental consent and, in that situation, information about that treatment cannot be disclosed to anyone without the individual’s agreement. While privacy in psychotherapy is very important, particularly with teenagers, parental involvement is also essential to successful treatment and this requires that some private information be shared with parents. It is our policy only to share information that is considered necessary with his/her parents. This includes general information about the progress of the child’s treatment and his/her attendance at scheduled sessions. Parents will also be provided with a summary of their child’s treatment when it is complete. Any other communication will require the child’s Authorization, unless the provider feels that the child is in danger or is a danger to someone else, in which case, the parents will be notified of this concern. Before giving parents any information, this will be discussed with the child, if possible, and an attempt will be made to handle any objections he/she may have. YOUR SIGNATURES ON THE FOLLOWING PAGE INDICATE THAT YOU HAVE 1) BEEN GIVEN THIS AGREEMENT AND 2) READ AND AGREE TO ITS TERMS. IT ALSO SERVES AS AN ACKNOWLEDGEMENT THAT YOU HAVE RECEIVED THE HIPAA NOTICE FORM DESCRIBED ABOVE.

MINORS & PARENTS. Individuals Children over the age of eighteen have the right to independently consent to and receive mental health treatment without parental consent and, in that situation, information about that treatment cannot be disclosed to anyone without the individual’s child's agreement. While privacy in psychotherapy is very important, particularly with teenagers, parental involvement is also essential to successful treatment and this requires that some private information be shared with parents. It is our my policy only to share information that is considered necessary with his/her parents. This includes general information about the progress of the child’s 's treatment and his/her attendance at scheduled sessions. Parents will also be provided with a summary of their child’s 's treatment when it is complete. Any other communication will require the child’s 's Authorization, unless the provider psychiatrist feels that the child child/adolescent is in danger or is a danger to someone else, in which case, the parents will be notified of this concern. Before giving parents any information, this will be discussed with the child/adolescent, if possible, and an attempt will be made to handle any objections he/she may have. ID-THEFT PREVENTION. According to the ID-Theft prevention policies of Xxxxxx X. Xxxxxxxx, MD, Inc. you will be required to bring a picture ID and your insurance card to your initial session. YOUR SIGNATURES ON THE FOLLOWING PAGE INDICATE THAT YOU HAVE 1) BEEN GIVEN THIS AGREEMENT AND 2) READ AND AGREE TO ITS TERMS. IT ALSO SERVES AS AN ACKNOWLEDGEMENT THAT YOU HAVE RECEIVED THE HIPAA PRIVACY NOTICE FORM DESCRIBED ABOVE.. Rev 02/10

MINORS & PARENTS. Individuals Children over the age of eighteen have the right to independently consent to and receive mental health treatment without parental consent and, in that situation, information about that treatment cannot be disclosed to anyone without the individualchild’s agreement. While privacy in psychotherapy is very important, particularly with teenagers, parental involvement is also essential to successful treatment and this requires that some private information be shared with parents. It is our policy only to share information that is considered necessary with his/her parents. This includes general information about the progress of the child’s treatment and his/her attendance at scheduled sessions. Parents will also be provided with a summary of their child’s treatment when it is complete. Any other communication will require the child’s Authorization, unless the provider feels that the child is in danger or is a danger to someone else, in which case, the parents will be notified of this concern. Before giving parents any information, this will be discussed with the child, if possible, and an attempt will be made to handle any objections he/she may have. YOUR SIGNATURES ON THE FOLLOWING PAGE INDICATE THAT YOU HAVE 1) BEEN GIVEN THIS AGREEMENT AND 2) READ AND AGREE TO ITS TERMS. IT ALSO SERVES AS AN ACKNOWLEDGEMENT THAT YOU HAVE RECEIVED THE HIPAA NOTICE FORM DESCRIBED ABOVE.. [ Rev 03/03 HRC PROVIDER-PATIENT SERVICES AGREEMENT

MINORS & PARENTS. Individuals Children over the age of eighteen have the right to independently consent to and receive mental health treatment without parental consent and, in that situation, information about that treatment cannot be disclosed to anyone without the individual’s child's agreement. While privacy in psychotherapy is very important, particularly with teenagers, parental involvement is also essential to successful treatment and this requires that some private information be shared with parents. It is our policy only to share information that is considered necessary with his/her a minor’s parents. This includes general information about the progress of the child’s 's treatment and his/her attendance at scheduled sessions. Parents will also be provided with a summary of their child’s 's treatment when it is completecomplete upon request. Any other communication will require the child’s Authorization's authorization, unless the provider therapist feels that the child is in danger or is a danger to someone else, in which case, the parents will be notified of this concern. Before giving parents any information, this will be discussed with the child, if possiblepractical, and an attempt will be made to handle any objections he/she may have. YOUR SIGNATURES AND INITIALS ON THE FOLLOWING PAGE INDICATE THAT YOU HAVE 1) BEEN GIVEN THIS AGREEMENT AND 2) READ AND AGREE TO ITS TERMS. IT ALSO SERVES AS AN ACKNOWLEDGEMENT THAT YOU HAVE RECEIVED THE HIPAA PRIVACY NOTICE FORM DESCRIBED ABOVE. THERAPIST-CLIENT SERVICES AGREEMENT- SIGNATURE PAGE Xxxxx X. Xxxxx, MA, MA, LPCA Grace Counseling, PLLC Signature Page This must be signed and received by your therapist at the beginning of your first session along with payment or your expected co-pay.

MINORS & PARENTS. Individuals over the age of eighteen have the right to independently consent to and receive mental health treatment without parental consent and, in that situation, information about that treatment cannot be disclosed to anyone without the individual’s agreement. While privacy in psychotherapy is very important, particularly with teenagers, parental involvement is also essential to successful treatment and this requires that some private information be shared with parents. It is our policy only to share information that is considered necessary with his/her parents. This includes general information about the progress of the child’s treatment and his/her attendance at scheduled sessions. Parents will also be provided with a summary of their child’s treatment when it is complete. Any other communication will require the child’s Authorization, unless the provider feels that the child is in danger or is a danger to someone else, in which case, the parents will be notified of this concern. Before giving parents any information, this will be discussed with the child, if possible, and an attempt will be made to handle any objections he/she may have. YOUR SIGNATURES ON THE FOLLOWING PAGE INDICATE THAT YOU HAVE 1) BEEN GIVEN THIS AGREEMENT AND 2) READ AND AGREE TO ITS TERMS. IT ALSO SERVES AS AN ACKNOWLEDGEMENT THAT YOU HAVE RECEIVED THE HIPAA NOTICE FORM DESCRIBED ABOVE.. [Rev 03/16] HRC PROVIDER-PATIENT SERVICES AGREEMENT

MINORS & PARENTS. Individuals Children over the age of eighteen have the right to independently consent to and receive mental health treatment without parental consent and, in that situation, information about that treatment cannot be disclosed to anyone without the individual’s child's agreement. While privacy in psychotherapy is very important, particularly with teenagers, parental involvement is also essential to successful treatment and this requires that some private information be shared with parents. It is our policy only to share information that is considered necessary with his/her parents. This includes general information about the progress of the child’s 's treatment and his/her attendance at scheduled sessions. Parents will also be provided with a summary of their child’s 's treatment when it is complete. Any other communication will require the child’s 's Authorization, unless the provider therapist feels that the child is in danger or is a danger to someone else, in which case, the parents will be notified of this concern. Before giving parents any information, this will be discussed with the child, if possible, and an attempt will be made to handle any objections he/she may have. REALITY CENTER MINISTRIES. Xxxxx X. Xxxxxxxx Xxxxxx, M.A., L.P.C. is an employee of Xxxxxxx X. Xxxxxxxx, Ph.D., Inc. and provides pro xxxx counseling services at Reality Center in Durham, NC for New Horizons and other participating students. In order to provide the best possible care for students, she will consult with Reality Center and New Horizons staff regarding student needs. We do not discuss students casually. The extent of information gathered is solely for the purpose of treatment. YOUR SIGNATURES ON THE FOLLOWING PAGE INDICATE THAT YOU HAVE 1) BEEN GIVEN THIS AGREEMENT AND 2) READ AND AGREE TO ITS TERMS. IT ALSO SERVES AS AN ACKNOWLEDGEMENT THAT YOU HAVE RECEIVED THE HIPAA PRIVACY NOTICE FORM DESCRIBED ABOVE. Rev 01/10 THERAPIST-CLIENT SERVICES AGREEMENT Xxxxx X. Xxxxxxxx Xxxxxx, M.A., L.P.C., N.C.C. XXXXXXX X. XXXXXXXX, PH.D., INC. Signature Page (This must be signed during your first session.)