Practice Policies and AgreementPolicies and Agreement • February 28th, 2021
Privacy is important to teenagers, and as such, children between 13 and 18 years of age have the right to confidentiality. There are exceptions, however. Information will be shared without confidentiality release in cases in which there is suspected child abuse, when the child is a danger to others, or in situations in which a child may be placing themselves in a potentially dangerous situation (e.g. significant substance abuse). Practicality speaking, parents and family are critical to treatment planning and are kept in close communication. Nonetheless, if an adolescent requests confidentiality outside of the above potentially dangerous areas, Dr. Webster will attempt to help the teenager with the issue at hand, and with how to most appropriately to involve their parents. Privacy is of upmost importance for adequate therapeutic work to occur with children and adolescents. Your support of this in your role as parent is critical to their treatment.
Ronald McDonald House Charities of DaytonPolicies and Agreement • April 20th, 2018
To give back to the community that generously supports us, we opened the Doty Community Room (DCR), a meeting space open for the public to reserve FREE of charge. To respect the comfort and privacy of our guest families and ensure all guests feel welcome, we ask that the following policies be observed.
Banquet Policies and AgreementPolicies and Agreement • November 2nd, 2017
• All food and beverages must be purchased through Ankeny Golf and Country Club, with the exception of wedding cake, mints and nuts.
School Policies and agreementPolicies and Agreement • August 20th, 2022
• Mattock School of Music policies have been developed to encourage and promote the joyful study of music in our students. Therefore, regular attendance by students is expected. Students who arrive late cannot be guaranteed a full class/lesson.
Stonebridge Golf & Country ClubPolicies and Agreement • May 12th, 2014
The Club will bill the member hosting the event at the Club or offsite catered event that Stonebridge supplies. The Club requires submittal of the estimated attendees for the event no later than 7 days prior to the event.
Written Financial Policies and AgreementPolicies and Agreement • May 31st, 2021
Thank you for choosing Glowing Smile Dental Studio. Our primary mission is to deliver the best and most comprehensive dental care available. An important part of the mission is making the cost of optimal care as easy and manageable for our patients as possible by offering easy and convenient payment options.
Office Policies and Agreement for ServicesPolicies and Agreement • October 13th, 2020
Welcome to my psychotherapy practice. This document will give you information about my practice, policies, and procedures so that you can decide if we can work together. Let me know if you have any questions or need more information. When you sign this document, it will represent an agreement between us.
Facility Usage Policies and AgreementPolicies and Agreement • August 19th, 2021
Fremont County, Colorado (the “County”) owns and operates the eastern portion of Pathfinder Regional Park for the benefit of the residents of Fremont County and the public. This portion of the Park consists of an Outdoor Arena for organizations or private parties, a Festival Site which includes all areas outside of the Outdoor Arena, and a Community Center with an auditorium, meeting room space and a commercial kitchen. Future plans still consist of an additional covered Arena for multi-purpose use to the east of the Community Center.
Extra-Curricular Activities Term 2, 2019-2020Policies and Agreement • November 8th, 2021
Registration will begin on Saturday, January 18th. Fees will be calculated on 8 guaranteed classes per session. Beginning and ending dates will vary each school year to allow for 8 classes per session. All fees must be paid at registration time. No spot will be reserved without payment. Registrations will be accepted on a first come, first served basis until the class is full. Class sizes will be set by the administration and will not be changed. All applications will be dated. The time of application will be recorded. There will be no discount or deduction if students register late for an activity or miss a class.
West Broward Student-Athlete Policies and AgreementPolicies and Agreement • October 16th, 2020
**The last page of this agreement is a signature page which must be signed and returned before participating in a sport. Only one must be signed per year and applies to all sports.
Reasons for Premarital Counseling 5 Typical Order of Service 6 Suggested Scripture Readings 7 General Info, and Wedding Coordinators 8 Decorations, Flowers and Photography 9 Music and Rehearsal, Fellowship Area 10 Children and Rice, Sound, Screens and...Policies and Agreement • May 3rd, 2011
□ We recommend doing this before reserving the reception hall. Fill out the Wedding Policy and Agreement Form and mail back to the church office. This must be done in order to secure your wedding date.
Practice Policies and AgreementPolicies and Agreement • May 27th, 2021
Privacy is important to teenagers, and as such, children between 13 and 18 years of age have the right to confidentiality. There are exceptions, however. Information will be shared without confidentiality release in cases in which there is suspected child abuse, the child is a danger to others, or in situations in which a child may be placing themselves in a potentially dangerous situation (e.g. significant substance abuse). Practicality speaking, parents and family are critical to treatment planning and are kept in close communication. Nonetheless, if an adolescent requests confidentiality outside of the above potentially dangerous areas, Dr. Webster will attempt to help the teenager with the issue at hand, and with how to most appropriately to involve their parents. Privacy is of upmost importance for adequate therapeutic work to occur with children and adolescents. Your support of this in your role as parent is critical to their treatment.
DOG POLICIES AND AGREEMENTPolicies and Agreement • September 5th, 2020
To assure the comfort and safety of our dog guests, our staff and other guests, we have established the following policies. Your full cooperation is essential to the success and continuation of our “dog friendly” policy. We with both you and your dog an enjoyable stay.
Policies and Agreement for Therapy ServicesPolicies and Agreement • May 28th, 2020
All information disclosed in our sessions and the written records of those sessions are confidential and may not be revealed to anyone without your informed consent, except where the law requires disclosure. Disclosure is required by law when there is a reasonable suspicion of child, dependent or elder abuse or neglect and when a client presents a danger to self, to others, to property or is gravely disabled. In addition, disclosure may be required in a legal proceeding. These policies are in keeping with the Personal Information Protection Electronic Documents Act 2004 (PIPEDA) and the Personal Health Information Protection Act 2004 (PHIPA).
School Policies and agreementPolicies and Agreement • October 8th, 2021
Mattock School of Music policies have been developed to encourage and promote the joyful study of music in our students. Therefore, regular attendance by students is expected. Students who arrive late cannot be guaranteed a full class/lesson.
Practice Policies and AgreementPolicies and Agreement • August 4th, 2021
Privacy is important for patients seeking treatments, and our clinic protects this right to privacy dearly. There are exceptions to confidentiality, however. Information will be shared without confidentiality release in cases in which there is suspected child abuse, when a patient is a danger to others, or themselves. Privacy is of upmost importance for adequate therapeutic work to occur. Your support of this is critical to your treatment.
Patient Policies and Agreement Regarding AppointmentsPolicies and Agreement • March 28th, 2017
Unfortunately, previous patients have had an extremely high number of broken appointments. The results of those numerous broken appointments have been unnecessary and sometimes painful for other patients in need of treatment. Therefore, the following regulations have been instituted to eliminate broken appointments and to treat motivated patients in a more timely manner. Failure to adhere to ALL these policies will result in a dismissal from this practice.
DOG POLICIES AND AGREEMENTPolicies and Agreement • January 28th, 2019
If dog is left unattended, please leave a contact number where you can easily be reached in case of an emergency or noise disturbance. Phone Number
EARLEY FAMILY DENTAL, PC PAYMENT POLICIES AND AGREEMENTPolicies and Agreement • June 24th, 2015
Stonebridge Golf & Country ClubPolicies and Agreement • January 23rd, 2019
The Club will bill the member hosting the event at the Club or offsite catered event that Stonebridge supplies. The Club requires submittal of the final numbers of reservations 14 days prior to the event. This number will represent the guaranteed number for billing purposes, and the Club will not bill for any number less than the guaranteed number reserved. Within 7 days of the event, the event host may not reduce the guaranteed number. However, if the number of guests attending the event exceeds the guaranteed number, the Club will bill for the additional guests. To prevent an interruption in food service, the Club requires notification of additional reservations. Room Set-up will need to be submitted no later than 2 weeks prior to event. Item and menu prices do not include the 20% service charge and the 7% sales tax. Remaining balance for event due the day prior to your event. (Alcoholic/products based on consumption/additions to be paid at the conclusion of your event) If a member c
Policies and Agreement ContractPolicies and Agreement • January 13th, 2017
For the purposes of this document, the term “client” means the person(s) owning the home and pet(s) and entering into contracted services for pet and/or home care. Kelsey’s Companion Care will be known herein as KCC.
Pershing Small Gym Usage Policies and Agreement (Updated December 19, 2021)Policies and Agreement • January 23rd, 2013
All persons requesting use of the Pershing Small Gym must submit a request via http://emspro.truman.edu. No telephone or email reservation requests will be accepted.
Pershing Small Gym Usage Policies and AgreementPolicies and Agreement • January 31st, 2017
THIS FORM MUST BE RECEIVED NO LATER THAN 72 HOURS PREVIOUS TO THE TIME REQUESTED, OR THE RESERVATION REQUEST MAY BE DECLINED AND/OR CANCELLED.
Lab Access and Equipment Borrowing Policies and AgreementPolicies and Agreement • January 21st, 2020
Use of the photo lab facilities and equipment is granted to students who are enrolled in PHO (and other approved) courses provided they agree to the policies and procedures stated in this document.
Financial and Appointment Policies and AgreementPolicies and Agreement • April 6th, 2015
As a courtesy to our patients and their families, we will gladly file the forms necessary to see that you receive the maximum benefits of your dental coverage and we will wait on payment from your insurance company. However, no dental insurance pays 100% of all charges. If your insurance company denies coverage, or we otherwise do not receive payment within 30 days of filing your claim, the amount will then become due and payable by you. Our practice management software tries to estimate your portion of the dental bill at each visit, but remember that your coverage is a contract between you and your insurance company and/or your employer and your insurance company. Although we make a good faith effort to assist you in obtaining your benefits, we cannot force your insurance company to pay. Regardless of the estimated insurance coverage, any fees incurred for services received will be your financial responsibility.
Pet Policies and AgreementPolicies and Agreement • January 27th, 2012
The tenant agrees to abide by the policies listed in this document and the landlord agrees to permit the tenant to keep the pet(s) described in this agreement in accordance with the policies.
Practice Policies and AgreementPolicies and Agreement • December 24th, 2020
Privacy is important for patients seeking treatments, and our clinic protects this right to privacy dearly. There are exceptions to confidentiality, however. Information will be shared without confidentiality release in cases in which there is suspected child abuse, when a patient is a danger to others, or themselves. Privacy is of upmost importance for adequate therapeutic work to occur. Your support of this is critical to your treatment.
BRANSON CEDARS RESORTPolicies and Agreement • February 5th, 2019
We here at Branson Cedars want you to enjoy our hot tubs if your unit includes one. If you are unsure whether your unit includes a hot tub please check our website or ASK. There are some common sense requirements that need to be adhered to however.
Precision Physical Therapy Policies and AgreementPolicies and Agreement • July 2nd, 2017
At Precision Physical Therapy of Fayette LLC, it is our goal to provide you with the most compassionate and individualized physical therapy care. With one-on-one appointments, our evidence-based evaluation and treatment approaches will allow for the highest quality outcomes and care, while restoring your prior level of function. The following policies regarding referrals, insurance coverage, scheduling, and appointments are to ensure that these goals are achieved promoting an exceptional physical therapy experience.
PoliciesPolicies and Agreement • June 16th, 2016
United Trustees AssociationPolicies and Agreement • November 28th, 2018
Ad Size Dimensions 1x Rate 4x Rate Full page: Outside Back Cover 7 ¼” x 7” $770 $670/ea. Inside Front Cover 7 ¼” x 9 ¼” $660 $595/ea. Inside Back Cover 7 ¼” x 9 ¼” $605 $530/ea. Other Inside 7 ¼” x 9 ¼” $550 $485/ea. 1/2 page inside vertical 7 ¼” x 4 ½” $385 $345/ea. 1/2 page inside horizontal 3 ½” x 9 ¼” $385 $345/ea.
ContractPolicies and Agreement • October 16th, 2023
Patient Financial Responsibility Policies and AgreementPolicies and Agreement • January 28th, 2022
In order to establish clear and straight-forward communication between our patients and practice, TotalCare has adopted the following policies. If you have any questions regarding these policies, please feel free to ask the front office staff to clarify the policies for you. We are dedicated to providing the best possible care and services to you. We regard your complete understanding of your financial responsibilities as an essential element of your care and treatment.
NORDIC LODGE DOG POLICIES AND AGREEMENTPolicies and Agreement • August 28th, 2020
The Nordic Lodge is pleased to welcome well behaved dogs as guests at our hotel. We have designated dog friendly rooms at the Nordic Lodge and request that at the time you book your reservation that you notify us that you will be bringing your dog(s) with you, so that we can arrange for you to Stay in one of our dog friendly rooms. All dog(s) must be registered with the front desk at check in and a fee of $50.00 per stay will be included in your overall total. We limit the number of dogs per room to two (2).
POLICIES AND AGREEMENT FORMPolicies and Agreement • June 8th, 2024
