Client Services and Consent AgreementClient Services and Consent Agreement • July 20th, 2012
I, the undersigned, wish to receive psychotherapy services from the Bell Center for Anxiety and Depression (the "Practice") and Elspeth Bell, Ph.D. ("Dr. Bell") and/or the clinicians employed by the Practice, each referred to as a “Provider” or together referred to as a “the Providers”. I understand that these psychotherapy services are offered subject to the following terms and conditions:
Claire Boyette McCullough, PhD, LCMHC-SClient Services and Consent Agreement • August 2nd, 2020 • North Carolina
Hello and welcome! I appreciate your courage In seeing out counseling and creating a therapeutic relationship with me, whether it is for you, your child, partner, or family. If you have any questions or concerns, please feel free to reach out to me either person or contact me via email. In the event of any conflict, the terms of this agreement shall control. This agreement shall be governed by North Carolina law. I am responsible for the clinical treatment that I provide and the contents of this document. Please read thoroughly.
Client Services and Consent AgreementClient Services and Consent Agreement • November 4th, 2020 • North Carolina
Hello and Welcome! I appreciate your courage to seek counseling and create a therapeutic relationship with me, whether it is for you or for your child or family. This document informs you of my role as a therapist and the nature of our counseling relationship. If you have any questions or concerns, please feel free to ask me in person or contact me by email or phone. In the event of any conflict, the terms of this agreement shall control. This agreement shall be governed by North Carolina law. I am responsible for the clinical treatment that I provide and the contents of this document. Please read thoroughly.
Client Services and Consent AgreementClient Services and Consent Agreement • August 8th, 2020
Welcome to BASE! We are looking forward to getting to know you. This document contains important information about our professional services and business policies. Although this document is long and sometimes complex, it is very important that you read it carefully. If you have any questions, please ask us prior to signing this form.
