CLIENT THERAPIST SERVICES AGREEMENT/INFORMED CONSENTClient Therapist Services Agreement • September 9th, 2021
Welcome to the Good Life Center for Mental Health, LLC. This document contains important information about our mental health professional services and business policies. Please read it carefully. When you sign this document, it will represent an agreement between us.
Michael “Raúl” Brown, MS, Ph.D., LCMHCA Client-Therapist Services AgreementClient-Therapist Services Agreement • May 22nd, 2023
This document contains important information about your therapist, your privacy, and our work together. It is important that you read this information carefully. Please let me know if you have any questions once you have read through it. Before treatment can proceed, you will be asked to sign this agreement.
PATRICIA O. SPROUSE LCMHCClient-Therapist Services Agreement • April 2nd, 2020
Welcome to my practice. This document (the Agreement) contains important information about my professional services and business policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law that provides privacy information protections and patient rights with regard to the use and disclosure of your Protected Health Information (PHI) used for the purpose of treatment, payment, and health care operations. HIPAA requires that I provide you with a Notice of Privacy Practices (the Notice) for use and disclosure of PHI for treatment, payment and health care operations. The Notice, which is attached to this Agreement, explains HIPAA and its application to your personal health information in greater detail. The law requires that I obtain your signature acknowledging that I have provided you with this information at the end of this session. Although these documents are long and sometimes complex, it is very important that y
CLIENT-THERAPIST SERVICES AGREEMENTClient-Therapist Services Agreement • September 27th, 2022
As a Licensed Clinical Social Worker, it is my aim to provide the most efficient, effective, and least restrictive treatment/evaluation intervention possible. If I do not believe that my skills and experience will be helpful to you, I will provide you with a resource in this community, which to my knowledge offers the services that you need. Therapy services are not easily described in general statements. They vary depending on the personalities of the therapist and client, and the particular problems that you hope to address. Therapy services are not like services received from a medical doctor. Instead, they call for a very active effort on your part. For example, if you are receiving therapy from me, in order for the therapy to be most successful, you will have to work on things we talk about both during our sessions and at home.
CLIENT/THERAPIST SERVICES AGREEMENTClient/Therapist Services Agreement • January 25th, 2022
My approach to treatment is an insight-oriented psychodynamic psychotherapy that utilizes cognitive behavioral techniques and strategies. This calls for an active effort and ongoing commitment from each of us. My role is to help you engage in a relational process involving your thoughts and feelings, life history, relationship patterns, and current symptoms to make meaningful changes in your life. It is important for us to maintain an open dialogue with each other about all aspects of our work together as it progresses.
Kelly Senn Reinecke LCSW, LLCClient-Therapist Services Agreement • August 11th, 2017
As a Licensed Clinical Social Worker, it is my aim to provide the most efficient, effective, and least restrictive treatment/evaluation intervention possible. If I do believe that my skills and experience will be helpful to you, I will provide you with a resource in this community, which to my knowledge, offers the services that you need. Therapy services are not easily described in general statements. They vary depending on the personalities of the therapist and client, and the particular problems that you hope to address. Therapy services are not like services received from a medical doctor. Instead, they call for a very active effort on your part. For example, if you are receiving therapyfrom me, in order for the therapy to be most successful, you will have to work on things we talk about both during our sessions and at home.
