Common Contracts
3 similar Agreement for Service / Informed Consent contracts
Rudi Lion, MA, MFT Lic.# MFT 48741Agreement for Service / Informed Consent • June 30th, 2022
This Agreement is intended to provide (herein “Patient”) with important information regarding the practices, polices and procedures of Rudi Lion (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.
Kiefer Rich, Licensed Marriage and Family TherapistAgreement for Service / Informed Consent • September 15th, 2017
(herein “Patient”) with important information regarding the practices, polices and procedures of Kiefer Rich (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.
Rebecca Zulim, M.A.Agreement for Service / Informed Consent • March 2nd, 2015
This Agreement is intended to provide [name of patient]_ (herein “Patient”) with important information regarding the practices, policies and procedures of Rebecca Zulim (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.
