Common Contracts

2 similar Client Services and Consent Agreement contracts

Client Services and Consent Agreement
Client Services and Consent Agreement • July 20th, 2012

I, the undersigned, wish to receive psychotherapy services from the Bell Center for Anxiety and Depression (the "Practice") and Elspeth Bell, Ph.D. ("Dr. Bell") and/or the clinicians employed by the Practice, each referred to as a “Provider” or together referred to as a “the Providers”. I understand that these psychotherapy services are offered subject to the following terms and conditions:

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Client Services and Consent Agreement
Client Services and Consent Agreement • July 20th, 2012

I, the undersigned, wish to receive psychotherapy services from the Bell Center for Anxiety and Depression (the "Practice") and Elspeth Bell, Ph.D. ("Dr. Bell") and/or the clinicians employed by the Practice, each referred to as a “Provider” or together referred to as a “the Providers”. I understand that these psychotherapy services are offered subject to the following terms and conditions:

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