Common Contracts
2 similar Patient Agreement contracts
PSYCHOTHERAPIST-PATIENT AGREEMENT/CONTRACTPatient Agreement • February 2nd, 2023
Welcome to my practice. This document contains important information about my professional services and business policies. Although these documents are long and sometimes complex, it is very important that you read them carefully. Please jot down any questions you might have about the procedures so that we can discuss them at that time. When you sign this document, it will represent an agreement between us. You may revoke this Agreement in writing at any time. That revocation will be binding on me unless I have taken action in reliance on it; if there are obligations imposed on me by your health insurer in order to process or substantiate claims made under your policy; or if you have not satisfied any financial obligations you have incurred.
PSYCHOTHERAPIST-PATIENT AGREEMENT/CONTRACTPatient Agreement • January 20th, 2023
Welcome to my practice. This document contains important information about my professional services and business policies. Although these documents are long and sometimes complex, it is very important that you read them carefully. Please jot down any questions you might have about the procedures so that we can discuss them at that time. When you sign this document, it will represent an agreement between us. You may revoke this Agreement in writing at any time. That revocation will be binding on me unless I have taken action in reliance on it; if there are obligations imposed on me by your health insurer in order to process or substantiate claims made under your policy; or if you have not satisfied any financial obligations you have incurred.
