Disclosure Statement & Agreement for Service ContractMay 28th, 2021
FiledMay 28th, 2021This Agreement is intended to provide [Name of Patient] with important information regarding our professional services and business practices. Please read it carefully and jot down any questions you might have so that you can discuss them with your therapist during your session. When you sign this document it will represent an agreement between us.
Disclosure Statement & Agreement for Service ContractJanuary 28th, 2020
FiledJanuary 28th, 2020This Agreement is intended to provide [Name of Patient] with important information regarding our professional services and business practices. Please read it carefully and jot down any questions you might have so that you can discuss them with your therapist during your session. When you sign this document it will represent an agreement between us.
Disclosure Statement & Agreement for Service ContractOctober 10th, 2017
FiledOctober 10th, 2017This Agreement is intended to provide [Name of Patient] with important information regarding our professional services and business practices. Please read it carefully and jot down any questions you might have so that you can discuss them with your therapist during your session. When you sign this document it will represent an agreement between us.
Disclosure Statement & Agreement for Service ContractSeptember 30th, 2016
FiledSeptember 30th, 2016This Agreement is intended to provide [Name of Patient] with important information regarding our professional services and business practices. Please read it carefully and jot down any questions you might have so that you can discuss them with your therapist during your session. When you sign this document it will represent an agreement between us.
Disclosure Statement & Agreement for Service ContractJuly 26th, 2014
FiledJuly 26th, 2014This Agreement is intended to provide [Name of Patient] _____________________________________________ with important information regarding our professional services and business practices. Please read it carefully and jot down any questions you might have so that you can discuss them with your therapist during your session. When you sign this document it will represent an agreement between us.