Adult Service Agreement Sample Contracts

PAULA L. MARCOLIN, MS, LPC
Adult Service Agreement • January 23rd, 2023

I, , consent to individual counseling with Paula Marcolin, MS, LPC. As a part of this agreement I understand I have chosen to attend counseling of my own free will and I may discontinue sessions at my own discretion.

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Greencastle Family Practice, PC Counseling Services John L. Grove Medical Center 50 Eastern Ave, Suite 115 Greencastle, PA 17225 Phone - (717) 597-0095 Fax - (717) 597-3147 Website - WWW.GFPPC.COM
Adult Service Agreement • August 1st, 2020

The following is an overview of the counseling services offered at the Greencastle Family Practice, P.C. Please read this information carefully and feel free to ask about anything that is unclear to you or about any concerns you might have. A copy of this form will be given to you and one will be kept in your file.

Adult Service Agreement
Adult Service Agreement • June 15th, 2022

Expectations: While there are no guaranteed outcomes in therapy, you can expect a safe environment that does not discriminate against age, sex, race, ethnic background, religion, disability, sexual orientation, or political affiliation. We strive to provide great treatment and, as part of providing the best service possible, you may receive email or phone contact(s) asking you about your experience. Unless otherwise indicated, your response will be shared with your therapist to help them improve their service to you. At any time, you may ask questions about your treatment, refuse to participate in specific tasks, or terminate services.

PAULA L. MARCOLIN, MS, LPC
Adult Service Agreement • February 22nd, 2022

I, , consent to individual counseling with Paula Marcolin, MS, LPC. As a part of this agreement I understand I have chosen to attend therapy of my own free will and I may discontinue sessions at my own discretion.

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