Psychologist-Patient Services AgreementPsychologist-Patient Services Agreement • August 24th, 2008
Contract Type FiledAugust 24th, 2008Welcome to my practice. This document contains important information about my professional services and business policies. Please read it carefully and ask about any aspects that are not clear to you. Your signature attests that you understand your rights and responsibilities and agree to them. You may revoke this Agreement in writing at anytime, unless 1) I have already taken action in reliance on it, 2) your health insurance company imposes obligations on me in order to process or substantiate claims, 3) or if you have not satisfied any financial obligations you have incurred.