Common Contracts
1 similar Consent for Treatment contracts
CONSENT FOR TREATMENTConsent for Treatment • March 17th, 2021
INFORMED CONSENT: This contract explains the conditions that you, as the client, have agreed upon when obtaining services through Center for Psychological Wellness, Inc. (hereafter referred to as CPWI). Some of these rights and obligations are imposed by Florida law while others are established herein by contractual agreement. Any concerns regarding the matters stated herein should be discussed prior to initiation of treatment. I understand that my records are protected under the applicable state law governing healthcare information that relates to mental health services and under the federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records 42 DRF Part 2, and cannot be disclosed without my written consent unless otherwise provided for in state or federal regulations. I also understand that I may revoke this consent at any time except to the extent that action has been taken in reliance on it.
