Common Contracts
2 similar Agreement contracts
Psychological Evaluation Agreement –For Insurance SubmissionAgreement • November 6th, 2020
Welcome to our practice. This document (the Agreement) contains important information about our professional services and business policies. The law requires that we obtain your signature acknowledging that we have provided you with this information at or before the end of the first meeting. Although these documents are long and sometimes complex, it is very important that you read them carefully. We can discuss any questions you have about the procedures during the first meeting. When you sign this document, it will also represent an agreement between us. You may revoke this Agreement in writing at any time. That revocation will be binding on me unless we have taken action in reliance on it; if there are obligations imposed on me by your health insurer in order to process or substantiate claims made under your policy; or if you have not satisfied any financial obligations you have incurred.
Psychological Evaluation Agreement –For Insurance SubmissionAgreement • September 29th, 2020
Welcome to our practice. This document (the Agreement) contains important information about our professional services and business policies. The law requires that we obtain your signature acknowledging that we have provided you with this information at or before the end of the first meeting. Although these documents are long and sometimes complex, it is very important that you read them carefully. We can discuss any questions you have about the procedures during the first meeting. When you sign this document, it will also represent an agreement between us. You may revoke this Agreement in writing at any time. That revocation will be binding on me unless we have taken action in reliance on it; if there are obligations imposed on me by your health insurer in order to process or substantiate claims made under your policy; or if you have not satisfied any financial obligations you have incurred.
