AGREEMENT FOR SERVICE / INFORMED CONSENTSeptember 24th, 2013
FiledSeptember 24th, 2013This Agreement is intended to provide [name of patient] ________________________________ (herein “Patient”) with important information regarding the practices, polices and procedures of Michelle Dadoun (herein “Therapist”), and to clarify the terms of the professional therapeutic relationship between Therapist and Patient. Any questions or concerns regarding the contents of this Agreement should be discussed with Therapist prior to signing it.