AGREEMENT FOR SERVICE / INFORMED CONSENT FOR MINORSService Agreement • April 19th, 2022
Contract Type FiledApril 19th, 2022Named (herein “Patient”) and is intended to provide [name of parent(s)/legal guardian(s)] (herein “Representative(s)”) with important information regarding the practices, polices and procedures of . (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.