Client Agreement/Informed Consent Sample Contracts

CLIENT AGREEMENT & INFORMED CONSENT
Client Agreement & Informed Consent • October 29th, 2017

Welcome to Embrace New Life, LLC! I am so glad that you have decided to take that important first step in reaching out for support. I appreciate you giving me the opportunity to work with you. This document is intended to provide you with information about my qualifications, treatment approach, and methods, business policies, and services offered as well as answer any other questions you have about what to expect and the nature of the counseling process.

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Client Agreement / Informed Consent
Client Agreement / Informed Consent • December 18th, 2018

Overview of Services: The Mission of The Caring Place (TCP) is to “serve(s) the community as a welcoming and purposeful organization, responding to the basic human needs of people in Georgetown and rural Williamson County.” As resources are available, TCP provides limited financial assistance with rent, mortgage and/or utility; transportation; certain medical, dental and optical procedures; prescriptions; and temporary shelter. Additional supportive assistance includes clothing and household items, food programs, and short-term case management. TCP’s service area includes Georgetown and northern Williamson County (Andice, Bartlett, Florence, Granger, Jarrell, Jonah, Schwertner, Walburg, Weir and the Hutto area within the Georgetown Independent School District.)

Contract
Client Agreement / Informed Consent • May 20th, 2010

Psychotherapy services are offered to individual adults, couples, families, and children, usually on a once-per-week basis. Clients of all ages and diversities are welcome and there is no limitation on number of sessions attended. Psychological services offered depend on the personality of the therapist and the client and the particular problems the client is experiencing. Thus, Mrs. Hamamcy may use a variety of methods to meet individual needs of the client.

Client Agreement/Informed Consent
Client Agreement/Informed Consent • October 25th, 2020

Counseling services are typically offered as needed, either on a once-per week basis or as determined by the client. Although there are many definitions and philosophies of counseling, the following is a brief description of the philosophy of the services I provide:

Contract
Client Agreement & Informed Consent • August 21st, 2024
Clearpoint Psychology LLC 97 S Liberty St
Client Agreement & Informed Consent • February 10th, 2021
Client Agreement & Informed Consent
Client Agreement & Informed Consent • June 15th, 2021

• I understand that the above named emergency contact will be contacted in the case of medical, mental health or other emergency perceived by Root to Crown Healing & Wellness, LLC providers. I understand that Root to Crown Healing & Wellness, LLC providers are required by law to warn/protect if there is serious threat to harm of self or others. In the event of immediate concern for danger, the above identified person may be contacted in addition to any necessary police or emergency personnel.

Counseling is a confidential process designed to help you address your concerns, come to a greater understanding of yourself, and learn effective coping strategies. It involves a relationship between you and a trained therapist who has a desire and...
Client Agreement/Informed Consent • July 3rd, 2018

All interactions with Renew Wellness Center (RWC) including scheduling of or attendance at appointments, content of your sessions, progress in counseling and your records are confidential.

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