Common Contracts
4 similar null contracts
Please give 24 hour notice to cancel your appointment to avoid the $100 cancelation feeApril 12th, 2017
Welcome to Summit Medical Group’s Behavioral Health and Cognitive Therapy Center (BHCTC). We thank you for choosing us for your counseling needs. This Office Information and Patient- Therapist Agreement (Agreement) includes important information about BHCTC’s services, office policies and expectations. It is important that you read this Agreement carefully and raise any questions you may have about it with your clinician. When you sign this Agreement, it creates an actual agreement between you and your clinician and both you and your clinician are expected to act in accordance with all of its terms, and that your clinician will expect you to do the same. You may revoke this Agreement in writing at any time; however, you may still be held to the Agreement’s payment obligations even though you have decided to revoke it. Please read the following information carefully and feel free to ask your clinician any questions during your meeting together. After reading this Agreement please sign i
Please give 24 hour notice to cancel your appointment to avoid the $100 cancelation feeOctober 1st, 2010
Welcome to Summit Medical Group’s Behavioral Health and Cognitive Therapy Center (BHCTC). We thank you for choosing us for your counseling needs. This Office Information and Patient- Therapist Agreement (Agreement) includes important information about BHCTC’s services, office policies and expectations. It is important that you read this Agreement carefully and raise any questions you may have about it with your clinician. When you sign this Agreement, it creates an actual agreement between you and your clinician and both you and your clinician are expected to act in accordance with all of its terms, and that your clinician will expect you to do the same. You may revoke this Agreement in writing at any time; however, you may still be held to the Agreement’s payment obligations even though you have decided to revoke it. Please read the following information carefully and feel free to ask your clinician any questions during your meeting together. After reading this Agreement please sign i
Please give 24 hour notice to cancel your appointment to avoid the $100 cancelation feeOctober 1st, 2010
Welcome to Summit Medical Group’s Behavioral Health and Cognitive Therapy Center (BHCTC). We thank you for choosing us for your counseling needs. This Office Information and Patient- Therapist Agreement (Agreement) includes important information about BHCTC’s services, office policies and expectations. It is important that you read this Agreement carefully and raise any questions you may have about it with your clinician. When you sign this Agreement, it creates an actual agreement between you and your clinician and both you and your clinician are expected to act in accordance with all of its terms, and that your clinician will expect you to do the same. You may revoke this Agreement in writing at any time; however, you may still be held to the Agreement’s payment obligations even though you have decided to revoke it. Please read the following information carefully and feel free to ask your clinician any questions during your meeting together. After reading this Agreement please sign i
Please give 24 hour notice to cancel your appointment to avoid the $100 cancelation feeOctober 1st, 2010
Welcome to Summit Medical Group’s Behavioral Health and Cognitive Therapy Center (BHCTC). We thank you for choosing us for your counseling needs. This Office Information and Patient- Therapist Agreement (Agreement) includes important information about BHCTC’s services, office policies and expectations. It is important that you read this Agreement carefully and raise any questions you may have about it with your clinician. When you sign this Agreement, it creates an actual agreement between you and your clinician and both you and your clinician are expected to act in accordance with all of its terms, and that your clinician will expect you to do the same. You may revoke this Agreement in writing at any time; however, you may still be held to the Agreement’s payment obligations even though you have decided to revoke it. Please read the following information carefully and feel free to ask your clinician any questions during your meeting together. After reading this Agreement please sign i
