Ole von Frausing-Borch, RN, MSEd, MFT = Counseling and Psychotherapy = Licensed Marriage and Family Therapist License # 8963 AGREEMENT FOR SERVICE / INFORMED CONSENTAgreement for Service / Informed Consent • March 22nd, 2016
Contract Type FiledMarch 22nd, 2016(herein “Client”) with important information regarding the practices, policies and procedures of Ole von Frausing-Borch, LMFT (herein “Therapist”), and to clarify the terms of the professional therapeutic relationship between Therapist and Client. Any questions or concerns regarding the contents of this Agreement should be discussed with Therapist prior to signing it.