Health History – Sample Contracts

AGREEMENT FOR PAYMENT AND FINANCIAL RESPONSIBILITIES
Health History – • July 12th, 2021

Care and Counseling is a non-profit counseling center, accredited by The Solihten Institute. The standard fee for a first evaluation appointment is $190 and the standard fee for ongoing counseling is $175 per 38-67 minute session. We also have a Client Assistance Fund for those whose income cannot support the standard fee. Annually we review fees and renew the agreement for payment. There is a cost of living increase typically 1-2% each year. Please complete the following and return to your counselor.

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