Common Contracts
3 similar Patient Services Agreement contracts
INFORMED CONSENT & THERAPIST-PATIENT SERVICES AGREEMENTPatient Services Agreement • November 29th, 2020
As you know, I work with a network of independent mental health professionals, under the name of InSight Counseling, LLC. This group is an association of independent practitioners who share certain expenses and administrative functions. While the independent practitioners share a name and office space, I want you to know that I am completely independent in providing you with clinical services and I alone am fully responsible for those services. My professional records are confidential and no member of the group can have access to them without your specific, written permission.
INFORMED CONSENT & PSYCHOLOGIST-PATIENT SERVICES AGREEMENTPatient Services Agreement • May 2nd, 2014
As you know, I work with a network of independent mental health professionals, under the name of InSight Counseling, LLC. This group is an association of independent practitioners who share certain expenses and administrative functions. While the independent practitioners share a name and office space, I want you to know that I am completely independent in providing you with clinical services and I alone am fully responsible for those services. My professional records are confidential and no member of the group can have access to them without your specific, written permission.
INFORMED CONSENT & PSYCHOLOGIST-PATIENT SERVICES AGREEMENTPatient Services Agreement • April 28th, 2014
As you know, I work with a network of independent mental health professionals, under the name of InSight Counseling, LLC. This group is an association of independent practicitioners who share certain expenses and administrative functions. While the independent practitioners share a name and office space, I want you to know that I am completely independent in providing you with clinical services and I alone am fully responsible for those services. My professional records are confidential and no member of the group can have access to them without your specific, written permission.
