Informed Consent and Treatment Agreement Sample Contracts

Informed Consent and Treatment Agreement for Subutex®/Suboxone® (Buprenorphine)
Informed Consent and Treatment Agreement • September 12th, 2016
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INFORMED CONSENT, TREATMENT AGREEMENT FOR PSYCHOLOGICAL SERVICES AND OFFICE POLICY
Informed Consent and Treatment Agreement • March 17th, 2020

Welcome to the psychotherapy practice of Pamela Flint, Ph.D. This document contains important information about my professional services and business practices. Please read it carefully and note any questions you might have so I can answer them. I am a licensed psychologist practicing cognitive behavioral therapy (CBT) in the treatment of mood and anxiety disorders. This therapy targets one’s thoughts and beliefs, mood states, and behavior.

INFORMED CONSENT, TREATMENT AGREEMENT FOR PSYCHOLOGICAL SERVICES AND OFFICE POLICY
Informed Consent and Treatment Agreement • April 23rd, 2015

Welcome to the professional practice of Timothy M. Lane, Ph.D., PLLC, Psychologist. This document contains important information about my professional services and business practices. Please read it carefully and note any questions you might have so I can answer them.

Informed Consent, Disclosure, and Agreement for Treatment
Informed Consent and Treatment Agreement • January 15th, 2020

Thank you for choosing me for your mental health care needs. As a trained and experienced psychotherapist, I am licensed by the State of California as a Marriage & Family Therapist (MFT# 52696) and as a Certified Massage Therapist (CMT# 2957). I have received education and training in a variety of therapeutic orientations, including crisis intervention, cognitive behavioral therapy (CBT), family systems, motivational interviewing, body-centered psychotherapy, somatic psychology, transpersonal psychology, and Jungian orientated psychology.

INFORMED CONSENT AND TREATMENT AGREEMENT USC PSYCHOLOGY SERVICES CENTER
Informed Consent and Treatment Agreement • August 13th, 2014

Welcome to USC’s Psychology Services Center (hereafter referred to as the “Center”). This document explains several important aspects of treatment at the Center, including treatment provided on-site and off- site by our therapists. Although this document is long and complex, it is important you read it carefully and ask any questions you might have. We will give you a copy to take home.

Informed Consent and Treatment Agreement for Subutex®/Suboxone® (Buprenorphine)
Informed Consent and Treatment Agreement • May 9th, 2014
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