AGREEMENT FOR SERVICE / INFORMED CONSENTOctober 18th, 2011
FiledOctober 18th, 2011This Agreement is intended to provide (herein “Patient”) with important information regarding the practices, policies and procedures of Ana Rebecca Toothman-Smith (herein “Therapist”), and to clarify the terms of the professional therapeutic relationship between Therapist and Patient. Any questions or concerns regarding the contents of this Agreement should be discussed with Therapist prior to signing it.