Common Contracts
1 similar Informed Consent/Service Agreement contracts
Northern New Jersey Therapy Cara L. McCloud, LCSWInformed Consent/Service Agreement • November 24th, 2020
This document contains important information about my professional services. Read each item below and initial in the space provided if you understand each item and agree to following. Once you sign this document, it will serve as an agreement between us. A parent or guardian of a Patient under the age of 18 must also read and understand each item before signing the agreement. Do not sign this agreement if there is anything that you do not understand about the information you have received or have not discussed at time of intake. Should you choose, you may revoke your consent for treatment at any time. In addition, this agreement will expire on termination of treatment and after all claims for treatment have been satisfied. Please read carefully and discuss with me any questions before signing and returning the copy
