Counseling ContractCounseling Contract • December 29th, 2022
Thank you for selecting me to meet your counseling needs. It is a privilege to serve you and I will do all I can to help with whatever need you have and to provide the highest quality of service. In order to better serve you the following information is being provided. Please examine it carefully. I will be happy to answer any questions regarding items for which you need additional clarification. Please initial all sections below to which you agree. Any sections not initialed will be discussed prior to treatment.
COUNSELING CONTRACTCounseling Contract • April 30th, 2021
PATIENT AGREEMENT: I agree to attend the scheduled appointments with all designated family members. Regular sessions are 45 minutes in length. We, the undersigned parent(s) or legal guardian(s) of , a minor, do hereby consent to counseling services by the above-named counselor. This authorization shall remain in effect until revoked in writing by the undersigned.
Counseling ContractCounseling Contract • August 5th, 2019
Thank you for giving me the opportunity to serve you in your counseling needs. Ipledge to give you the best care that I can and will deliver to you the highest quality of service. In order to meet your needs the following information is provided for your consideration. Please read this carefully and ask any questions that you may have.
CLIENT CONTACT DETAILSCounseling Contract • February 21st, 2024
COUNSELING CONTRACTCounseling Contract • May 28th, 2021
PATIENT AGREEMENT: I agree to attend the scheduled appointments with all designated family members. Regular sessions are 45 minutes in length. We, the undersigned parent(s) or legal guardian(s) of , a minor, do hereby consent to counseling services by the above-named counselor. This authorization shall remain in effect until revoked in writing by the undersigned.
COUNSELING CONTRACT Jennifer A. Prins, M.S.W., L.C.S.W.Counseling Contract • March 23rd, 2013
Thank you for considering me for your therapy needs. Therapy occurs in a relationship that is close and personal, yet also must be kept in a professional context to be therapeutic. These guidelines are designed to help set the boundaries of our relationship. My desire is to do everything within my professional capacity to be helpful to you.
COUNSELING CONTRACTCounseling Contract • April 30th, 2021
PATIENT AGREEMENT: I agree to attend the scheduled appointments with all designated family members. Regular sessions are 45 minutes in length. We, the undersigned parent(s) or legal guardian(s) of , a minor, do hereby consent to counseling services by the above-named counselor. This authorization shall remain in effect until revoked in writing by the undersigned.
Counseling ContractCounseling Contract • October 17th, 2018
Thank you for selecting me to meet your counseling needs. It is a privilege to work with you and I am committed to caring for you with excellence. The following information is provided to assist in standardizing expectations. Please examine it carefully and ask for clarification where needed.
Counseling ContractCounseling Contract • April 8th, 2017
Thank you for selecting me to meet your counseling needs. It is a privilege to serve you and I will do all I can to help with whatever need you have and to provide the highest quality of service. In order to better serve you the following information is being provided. Please examine it carefully. I will be happy to answer any questions regarding items for which you need additional clarification.
Counseling ContractCounseling Contract • September 13th, 2021
Thank you for selecting me to meet your counseling needs. It is a privilege to serve you and I will do all I can to help with whatever need you have and to provide the highest quality of service. In order to better serve you the following information is being provided. Please examine it carefully. I will be happy to answer any questions regarding items for which you need additional clarification.
Counseling Contract Neide da Silva-Torres, MA, LPC, NCC 913-274-9147Counseling Contract • March 24th, 2022
Thank you for selecting me to meet your counseling needs. It is a privilege to serve you and I will do all I can to help with whatever need you have and to provide the highest quality of service. In order to better serve you the following information is being provided. Please examine it carefully. I will be happy to answer any questions regarding items for which you need additional clarification.
