Common Contracts
1 similar Consent for Treatment contracts
Consent for Treatment/ Acknowledgment Agreement Signature FormConsent for Treatment • June 1st, 2021
Patients must give voluntary consent for mental health treatment. Your signature (or that of your legal guardian) will demonstrate consent for receiving mental health treatment from the Psychiatric Wellness Center. I voluntarily consent to mental health treatment as performed by the Psychiatric Wellness Center and its employees. This treatment may include but not limited to: assessment, screening, consultation and recommendations, psychotherapy, holistic services and psychiatric medication management. I understand that mental health treatment may involve certain risks and benefits and I understand these risks and benefits. I also understand the risks and benefits of declining treatment. I am also aware that I have the right to request information about alternative treatment options, should they exist. I have read the above information and I authorize the Psychiatric Wellness Center to provide mental health services to myself or this patient (if guardian).
