Common Contracts
2 similar Therapist-Client Psychological Services Contract contracts
Therapist-Client Psychological Services ContractTherapist-Client Psychological Services Contract • August 9th, 2020
This document (the Contract) contains important information about the professional services and business policies of Raleigh Psychological Associates-Jackelin Veloz-Jefferson, Ed.S. a Professional Corporation. In this document “You” refers to the adult patient or to the Responsible Party of a minor patient seeking psychological services. You must indicate your understanding and acceptance of terms of this Contract by signing the Master Signature page in order to become an established patient or client. Please read it carefully first. You may revoke the agreement any time by giving written notice. Revocation will be binding except to the extent action was taken in reliance on it, such as unfulfilled obligations imposed by the health insurer, court order, or collection of any outstanding financial obligations.
Therapist-Client Psychological Services ContractTherapist-Client Psychological Services Contract • August 9th, 2020
This document (the Contract) contains important information about the professional services and business policies of Raleigh Psychological Associates-Jackelin Veloz-Jefferson, Ed.S. a Professional Corporation. In this document “You” refers to the adult patient or to the Responsible Party of a minor patient seeking psychological services. You must indicate your understanding and acceptance of terms of this Contract by signing the Master Signature page in order to become an established patient or client. Please read it carefully first. You may revoke the agreement any time by giving written notice. Revocation will be binding except to the extent action was taken in reliance on it, such as unfulfilled obligations imposed by the health insurer, court order, or collection of any outstanding financial obligations.
