CLIENT - THERAPIST AGREEMENTTherapist Agreement • September 9th, 2021
Contract Type FiledSeptember 9th, 2021When you receive any type of service for mental illness, alcoholism, drug abuse, or a developmental disability, you have the following rights under Wisconsin Statute sec
Dawn Lewis, MS, LCPC, NCC, DCCTherapist Agreement • May 18th, 2017
Contract Type FiledMay 18th, 2017This Client-Therapist Agreement (the “Agreement”) has been created for the purpose of outlining the terms and conditions of counseling services to be provided by Dawn Lewis, MS, LCPC, NCC at Contemplative Counseling (the “Therapist”) to the Client(s). The “Client(s)” in this agreement are identified as:
MASSAGE THERAPIST AGREEMENTTherapist Agreement • November 17th, 2018
Contract Type FiledNovember 17th, 2018
Office Information and Patient-Therapist AgreementTherapist Agreement • October 1st, 2010
Contract Type FiledOctober 1st, 2010Welcome to Summit Medical Group’s Behavioral Health and Cognitive Therapy Center (BHCTC). We thank you for choosing us for your counseling needs. This Office Information and Patient- Therapist Agreement (Agreement) includes important information about BHCTC’s services, office policies and expectations. It is important that you read this Agreement carefully and raise any questions you may have about it with your clinician. When you sign this Agreement, it creates an actual agreement between you and your clinician and both you and your clinician are expected to act in accordance with all of its terms, and that your clinician will expect you to do the same. You may revoke this Agreement in writing at any time; however, you may still be held to the Agreement’s payment obligations even though you have decided to revoke it. Please read the following information carefully and feel free to ask your clinician any questions during your meeting together. After reading this Agreement please sign i
CLIENT: THERAPIST AGREEMENTTherapist Agreement • July 30th, 2021
Contract Type FiledJuly 30th, 2021If you choose to work with me, our relationship will be built on mutual trust and respect. Everything we discuss is confidential.
Parent/Therapist AgreementTherapist Agreement • October 24th, 2019
Contract Type FiledOctober 24th, 2019This is an agreement between ……………………………(parent), parent of ……………………………… and Denise McDermott (therapist) prior to the commencement of play therapy sessions.
Intern Therapist Agreement AddendumTherapist Agreement • November 7th, 2022
Contract Type FiledNovember 7th, 2022
Player Welfare Service: Therapist AgreementTherapist Agreement • September 1st, 2021
Contract Type FiledSeptember 1st, 2021We are committed to offering specialised pitch side first aid to our clients. We are also dedicated to finding pitch side first aid work for all therapists and healthcare practitioners. In return, PS stipulate basic professionalism and courtesy from all therapists.
CLIENT/THERAPIST AGREEMENTTherapist Agreement • September 19th, 2018
Contract Type FiledSeptember 19th, 2018Services: Therapist agrees to provide psychotherapy services to the client. These services may include individual, couple or family therapy as well as any other services that are recommended by the therapist. Any recommendations for treatment will thoroughly be discussed with the client.
TONNA G. PALLAS, LCSWTherapist Agreement • October 20th, 2019
Contract Type FiledOctober 20th, 2019The process of psychotherapy is an active one that involves both the client and the therapist. The following policies are identified so that you can make the best use of your psychotherapy time.
Office Information and Patient-Therapist AgreementTherapist Agreement • July 6th, 2018
Contract Type FiledJuly 6th, 2018Welcome to Summit Medical Group’s Behavioral Health and Cognitive Therapy Center (BHCTC). We thank you for choosing us for your counseling needs. This Office Information and Patient-Therapist Agreement (Agreement) includes important information about BHCTC’s services, office policies and expectations. It is important that you read this Agreement carefully and raise any questions you may have about it with your clinician. When you sign this Agreement, it creates an actual agreement between you and your clinician and both you and your clinician are expected to act in accordance with all of its terms, and that your clinician will expect you to do the same. You may revoke this Agreement in writing at any time; however, you may still be held to the Agreement’s payment obligations even though you have decided to revoke it. Please read the following information carefully and feel free to ask your clinician any questions during your meeting together. After reading this Agreement please sign it
Client – Trainer/Therapist AgreementTherapist Agreement • May 19th, 2022
Contract Type FiledMay 19th, 2022To avoid confusion and safeguard both parties the following definitions, guidelines and Terms and Conditions must be agreed and accepted in advance by the Client.
Shimmy Feintuch, LCSW CASAC-GTherapist Agreement • December 5th, 2023
Contract Type FiledDecember 5th, 2023The therapy relationship is a collaborative one. You and I will establish goals together, and it is my role to help you work to accomplish them. In order to facilitate our work, there are a number of policies and procedures that need to be followed. They are outlined below.
CLIENT/THERAPIST AGREEMENTTherapist Agreement • February 11th, 2017
Contract Type FiledFebruary 11th, 2017The following information may be helpful in answering your questions, and clarifying the policies and procedures for my practice.
Client / Therapist AgreementTherapist Agreement • August 6th, 2018
Contract Type FiledAugust 6th, 2018By signing below, you are agreeing to having your child assessed and to cooperate fully and to the best of your ability. Your signature below also indicates that you agree to the following:
Player Welfare Service: Therapist AgreementTherapist Agreement • October 5th, 2023
Contract Type FiledOctober 5th, 2023We are committed to offering specialised pitch side first aid to our clients. We are also dedicated to finding pitch side first aid work for all sports related physical therapists. In return, Physio Science stipulate basic professionalism and courtesy from all therapists.
Parent/Therapist AgreementTherapist Agreement • September 12th, 2023
Contract Type FiledSeptember 12th, 2023This is an agreement between ……………………………(parent) and……………………………(parent), parents of ……………………………… and Denise McDermott (therapist) prior to the commencement of play therapy/young person psychotherapy sessions. Please note the consent of both parents is required to commence therapy. If it is not possible to obtain both signatures please discuss this with Denise.
Dawn Lewis, MS, LCPC, NCC, DCCTherapist Agreement • August 30th, 2014
Contract Type FiledAugust 30th, 2014This Client-Therapist Agreement (the “Agreement”) has been created for the purpose of outlining the terms and conditions of counseling services to be provided by Dawn Lewis, MS, LCPC, NCC at Contemplative Counseling (the “Therapist”) to the Client(s). The “Client(s)” in this agreement are identified as:
Client-Therapist AgreementTherapist Agreement • May 30th, 2020
Contract Type FiledMay 30th, 2020Regarding confidentiality: The law, professional ethics, and common sense require that whatever you say or do during a psychotherapy session not be shared with anyone else without your written permission. There are, however, certain exceptions to this rule:
Client / Therapist AgreementTherapist Agreement • May 3rd, 2018
Contract Type FiledMay 3rd, 2018By signing below, you are agreeing to having your child assessed and to cooperate fully and to the best of your ability. Your signature below also indicates that you:
MASSAGE THERAPIST AGREEMENTTherapist Agreement • November 17th, 2018
Contract Type FiledNovember 17th, 2018
REBECCA SMITH-WOODY, LPC. CLIENT - THERAPIST AGREEMENTTherapist Agreement • October 2nd, 2021
Contract Type FiledOctober 2nd, 2021The process of psychotherapy is an active one that involves both the client and the therapist. The following policies are identified so that you can make the best use of your therapy sessions.
Parent/Therapist AgreementTherapist Agreement • September 27th, 2019
Contract Type FiledSeptember 27th, 2019This is an agreement between ……………………………(parent), parent of ……………………………… and Denise McDermott (therapist) prior to the commencement of play therapy sessions.
Parent/Therapist AgreementTherapist Agreement • May 21st, 2021
Contract Type FiledMay 21st, 2021This is an agreement between ………………………………………………………………..(parent/s), parent of ……………………………… and Denise McDermott (therapist) prior to the commencement of child psychotherapy therapy sessions. Please note both parents must sign this form where both parents are recognised as legal guardians of the child. If this is not possible to obtain, I will discuss this with my child’s therapist.
Client / Therapist AgreementTherapist Agreement • May 3rd, 2018
Contract Type FiledMay 3rd, 2018By signing below, you are agreeing to having your child assessed and to cooperate fully and to the best of your ability. Your signature below also indicates that you:
NORTH CAROLINA STATE UNIVERSITY MASSAGE THERAPIST AGREEMENTTherapist Agreement • June 5th, 2019 • North Carolina
Contract Type FiledJune 5th, 2019 Jurisdiction(“Contractor”), and North Carolina State University, c/o Student Health Services, Campus Box 7304, Raleigh, North Carolina 27695 (“NC State”).
CLIENT - THERAPIST AGREEMENTTherapist Agreement • September 22nd, 2015
Contract Type FiledSeptember 22nd, 2015The practice of both licensed and unlicensed persons in the field of psychotherapy is regulated by the Colorado State Department of Regulatory Agencies. Any concerns may be addressed to the appropriate licensing board or:
CLIENT/THERAPIST AGREEMENT - Client CopyTherapist Agreement • January 3rd, 2013
Contract Type FiledJanuary 3rd, 2013The following information may be helpful in answering your questions, and clarifying the policies and procedures for my practice.
MASSAGE THERAPIST AGREEMENTTherapist Agreement • November 17th, 2018
Contract Type FiledNovember 17th, 2018