Psychological Evaluation Agreement –For Insurance SubmissionPsychological Evaluation Agreement • November 6th, 2020
Welcome to our practice. This document (the Agreement) contains important information about our professional services and business policies. The law requires that we obtain your signature acknowledging that we have provided you with this information at or before the end of the first meeting. Although these documents are long and sometimes complex, it is very important that you read them carefully. We can discuss any questions you have about the procedures during the first meeting. When you sign this document, it will also represent an agreement between us. You may revoke this Agreement in writing at any time. That revocation will be binding on me unless we have taken action in reliance on it; if there are obligations imposed on me by your health insurer in order to process or substantiate claims made under your policy; or if you have not satisfied any financial obligations you have incurred.
STATE OF TEXAS )Psychological Evaluation Agreement • August 5th, 2010
This agreement is entered into by and between El Paso County on behalf of the El Paso County Juvenile Probation Department, hereinafter known as "JPD," and Guido A. Barrientos, Ph.D., hereinafter known as "Contractor".
FULL BATTERY PSYCHOLOGICAL EVALUATIONSPsychological Evaluation Agreement • February 28th, 2013
This agreement is entered into by and between El Paso County, on behalf of the Juvenile Probation Department, hereinafter known as "JPD" and Amanecer Psychological Services, P.C., hereinafter known as "Contractor" to provide full battery psychological evaluations.
AGREEMENT FOR PSYCHOLOGICAL EVALUATIONSPsychological Evaluation Agreement • April 1st, 2021
This Agreement (“Agreement”) is made and entered into on [DATE], by and between [NAME] (“School Psychologist”) and the Wayne County Board of Education (“WCBOE”) (collectively, the “Parties”) to conduct psychological testing and evaluations for designated students of Wayne County Public Schools (“WCPS”), to draft psycho-educational reports, and participate in Individualized Education Program (“IEP”) meetings for the designated WCPS students consistent with the applicable federal and state law, NC State Board of Education and Wayne County Board of Education policies.
