Consent to Receive Psychological Services Sample Contracts

CONSENT TO RECEIVE PSYCHOLOGICAL SERVICES; CONFIDENTIALITY STATEMENT; PAYMENT AGREEMENT
Consent to Receive Psychological Services • October 24th, 2021

I, , understand that psychotherapy and psychological testing have both potential risks as well as potential benefits. I understand that the risks may include, for example, uncomfortable levels of unpleasant emotions. It is also possible that individuals receiving therapy may feel worse, emotionally, before they begin to feel better due to the exploring of uncomfortable experiences and topics.

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CONSENT TO RECEIVE PSYCHOLOGICAL SERVICES; CONFIDENTIALITY STATEMENT; PAYMENT AGREEMENT
Consent to Receive Psychological Services • October 24th, 2021

I, , understand that psychotherapy and psychological testing have both potential risks as well as potential benefits. I understand that the risks may include, for ex- ample, uncomfortable levels of unpleasant emotions. It is also possible that individuals receiving therapy may feel worse, emotionally, before they begin to feel better due to the exploring of un- comfortable experiences and topics.

Acknowledgment and Agreement
Consent to Receive Psychological Services • November 29th, 2011
CONSENT TO RECEIVE PSYCHOLOGICAL SERVICES CONFIDENTIALITY STATEMENT & PAYMENT AGREEMENT
Consent to Receive Psychological Services • April 3rd, 2020

I, , understand that psychotherapy and psychological testing have both potential risks as well as potential benefits. I understand that the risks may include, for example, uncomfortable levels of unpleasant emotions and that individuals receiving therapy may feel worse, emotionally, before they begin to feel better.

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