Informed Consent and Agreement for Psychotherapy Services With Deanna M. Stassi, M.A. Licensed Professional CounselorInformed Consent and Agreement for Psychotherapy Services • February 16th, 2019
Welcome! I am pleased to have the opportunity to work with you. This document is designed to provide you with important information about my professional services as well as my business policies and procedures. Please read this agreement carefully before signing as it represents an agreement between us. Feel free to bring in any questions and/or concerns about the agreement or my qualifications to your initial session.
Informed Consent and Agreement for Psychotherapy ServicesInformed Consent and Agreement for Psychotherapy Services • September 23rd, 2019
This document is intended to provide important information to you regarding your therapy. Please read the entire document carefully and be sure to ask me any questions that you may have regarding its contents. You may have questions about me, my qualifications, therapy in general, or anything not addressed here. It is your right to have a complete explanation for any questions you may have, now or in the future. Please feel free to ask questions or share any concerns that may arise. Although I know this may be uncomfortable at times, your openness and honesty will allow me to better serve you.
Deb Ross, M.A., LMFTInformed Consent and Agreement for Psychotherapy Services • January 26th, 2022
CONFIDENTIALITY: All information disclosed within sessions and written records pertaining to those sessions are confidential and may not be revealed to anyone without your written permission except where disclosure is required by law: where there is a reasonable suspicion of child, dependent, or elder abuse or neglect: when a client presents a danger to self, others or property: when a client has been involved in an unsolved crime. When treating couples and families, or when family members are involved in an individual’s therapy sessions, confidentiality and privilege do not apply between treatment members unless it is otherwise agreed upon and clinical judgment will be used when revealing such information.
Aleta Edwards, Psy.D. 12505 Twisted Oak Drive Tampa, Florida 33624Informed Consent and Agreement for Psychotherapy Services • August 29th, 2020
Goal: I am in private practice of mental health counseling. To provide therapy to individuals who seek support in improving the quality of their lives, families and relationships.
