Evaluation and Treatment Agreement Sample Contracts

SEVITAR OFFICE POLICIES AND GENERAL INFORMATION, EVALUATION AND TREATMENT AGREEMENT
Evaluation and Treatment Agreement • January 29th, 2024

This form provides you (the client) with information that is additional to that detailed in the Notice of Privacy Practices and it is subject to HIPAA pre-emptive analysis.

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REBECCA M. CRABB, Ph.D.
Evaluation and Treatment Agreement • August 6th, 2017

Welcome! This document contains important information about the professional services and business policies of Rebecca M. Crabb, Ph.D. Please read this document carefully and ask me any questions that you have before signing.

SEVITAR OFFICE POLICIES AND GENERAL INFORMATION, EVALUATION AND TREATMENT AGREEMENT
Evaluation and Treatment Agreement • September 5th, 2024

This form provides you (the client) with information that is additional to that detailed in the Notice of Privacy Practices and it is subject to HIPAA pre-emptive analysis.

Evaluation and Treatment Agreement
Evaluation and Treatment Agreement • February 21st, 2018

This document contains important information about the professional services and business policies of Hannah Bosley, M.A., and Dr. Jacqueline B. Persons and the Oakland Cognitive Behavior Therapy Center. Please read it carefully and discuss any questions you have with Ms. Bosley or Dr. Persons.

Evaluation and Treatment Agreement
Evaluation and Treatment Agreement • May 1st, 2014

This document contains important information about the professional services and business policies of Janie J. Hong, Ph.D. and the Cognitive Behavior Therapy (CBT) and Science Center. Please read it carefully and discuss any questions you have with Dr. Hong.

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