Common Contracts
2 similar Informed Consent and Practice Policies contracts
Informed Consent and Practice PoliciesInformed Consent and Practice Policies • October 14th, 2020
The Washington Administrative Code requires that I, Greg Kiper, SUDP, LMHC, inform you of the form of treatment I provide, my fee, and educational background, including experience. This document provides you with important information about my professional services and office policies. Although it may seem like a lot of information, it is very important for you to carefully read this agreement and the other handouts I have included so we can discuss any questions you may have. At the end of this document, I have asked you to sign it indicating that you have read, understand and accept this agreement and the other documents I have included with it. You can revoke this agreement in writing at any time. Generally, I will consider your written revocation request as binding except in a few circumstances. These are: (1) If I have taken action in reliance on the agreement; (2) if you have not satisfied financial obligations you have incurred with me.
Informed Consent and Practice PoliciesInformed Consent and Practice Policies • December 31st, 2018
The Washington Administrative Code requires that I, Greg Kiper, CDP, LMHC, inform you of the form of treatment I provide, my fee, and educational background, including experience. This document provides you with important information about my professional services and office policies. Although it may seem like a lot of information, it is very important for you to carefully read this agreement and the other handouts I have included so we can discuss any questions you may have. At the end of this document, I have asked you to sign it indicating that you have read, understand and accept this agreement and the other documents I have included with it. You can revoke this agreement in writing at any time. Generally, I will consider your written revocation request as binding except in a few circumstances. These are: (1) If I have taken action in reliance on the agreement; (2) if you have not satisfied financial obligations you have incurred with me.
