INFORMED CONSENT AND THERAPY AGREEMENTInformed Consent and Therapy Agreement • December 2nd, 2022
your rights. Please read it carefully and make note of any questions you may have so that we can address them together. It is important to note that you have the right to refuse treatment and you may also revoke your consent in writing at any time.
INFORMED CONSENT AND THERAPY AGREEMENTInformed Consent and Therapy Agreement • July 24th, 2020
Thank you for choosing me as your therapist, I am honored to serve you. The therapeutic relationship is unique in that it is a highly personal and at the same time, a contractual agreement. Given this, it is important for us to reach a clear understanding about how our relationship will work, and what each of us can expect. This consent will provide a clear framework for our work together. Feel free to discuss any of this with me. Please read and indicate that you have reviewed this information and that you understand and agree to it by signing at the end of the form.
INFORMED CONSENT AND THERAPY AGREEMENTInformed Consent and Therapy Agreement • August 27th, 2021
I, the patient, understand I have the right not to sign this form. My signature below indicates I have read and discussed this agreement; it does not indicate that I am waiving any of my rights. I understand I can choose to discuss my concerns with you, the therapist, before I start formal therapy. I also understand that any of the points mentioned above can be discussed and may be open to change. If at any time during the treatment I have questions about any of the subjects discussed, I can talk with you about them, and you will do your best to answer them.
INFORMED CONSENT AND THERAPY AGREEMENTInformed Consent and Therapy Agreement • September 13th, 2021
I, the patient, understand I have the right not to sign this form. My signature below indicates I have read and discussed this agreement; it does not indicate that I am waiving any of my rights. I understand I can choose to discuss my concerns with you, the therapist intern, before I start formal therapy. I also understand that any of the points mentioned above can be discussed and may be open to change. If at any time during the treatment I have questions about any of the subjects discussed, I can talk with you about them, and you will do your best to answer them.
INFORMED CONSENT AND THERAPY AGREEMENTInformed Consent and Therapy Agreement • March 5th, 2018
I, the patient, understand I have the right not to sign this form. My signature below indicates I have read and discussed this agreement; it does not indicate that I am waiving any of my rights. I understand I can choose to discuss my concerns with you, the therapist, before I start formal therapy. I also understand that any of the points mentioned above can be discussed and may be open to change. If at any time during the treatment I have questions about any of the subjects discussed, I can talk with you about them, and you will do your best to answer them.
INFORMED CONSENT AND THERAPY AGREEMENTInformed Consent and Therapy Agreement • November 17th, 2020
I, the patient, understand I have the right not to sign this form. My signature below indicates I have read and discussed this agreement; it does not indicate that I am waiving any of my rights. I understand I can choose to discuss my concerns with you, the therapist, before I start formal therapy. I also understand that any of the points mentioned above can be discussed and may be open to change. If at any time during the treatment I have questions about any of the subjects discussed, I can talk with you about them, and you will do your best to answer them.
CLEAR LAKE CHILDREN’S CENTER INFORMED CONSENT AND THERAPY AGREEMENTInformed Consent and Therapy Agreement • June 19th, 2017
Welcome to Clear Lake Children’s Center. This document contains important information about the practice, its business policies, and your rights. Please read it carefully and make note of any questions you may have so that we can address them together. It is important to note that you have the right to refuse treatment and you may also revoke your consent in writing at any time.
