Office Policies / Treatment Agreement Sample Contracts

Tricia K. Buttkus, LCSW Licensed Psychotherapist, LCS 15889 (714) 974-­‐1621
Office Policies/Treatment Agreement • April 26th, 2023

The psychological practice of Tricia K. Buttkus, LCSW, is a solo practice, and is not associated with other practices in this suite. The fee for each 60-­‐minute individual therapy session is $150.00. Full payment for cash accounts required at end of each session unless other arrangements have been made in advance. Forms, Letters, Reports (prorated at 60 minutes) are $150.00. Tricia K. Buttkus, LCSW, does not testify in child custody cases or 730 evaluations. (Please initial )

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OFFICE POLICIES / TREATMENT AGREEMENT
Office Policies / Treatment Agreement • December 4th, 2020

Our mission is to provide you with personalized attention and care in a warm and friendly environment. We maintain our schedule by only booking one appointment at any given time allowing the doctor and nurse practitioners (NPs) to spend more time with you addressing your concerns and as this helps minimize any wait that you might experience. We are able to provide this by asking that you abide by our office policies and treatment agreement.

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