Getting Started. Parents have the option of requesting introductory sessions with us before contracting for services. These introductory sessions are billed at our regular hourly rates reflected earlier in this document for each provider in attendance, and allow the parents to meet us and to ask any questions they may have about the process. Once it is agreed upon that we will be working with your family as reunification providers, this agreement must be signed. The parties make an initial deposit of $5,000.00, which will secure our beginning work together. The initial deposit, the signed agreement, and a copy of any court orders requiring reunification process must be received prior to scheduling or holding any additional appointments. CONSENT FOR SERVICES P1: P2: _ I have received and understand the Notice of Privacy Policy regarding my privacy rights per federal HIPAA laws. P1: P2: _ P1: P2: _ I have received and understand the Minnesota Client Xxxx of Rights. Consent for Services: With enough knowledge, and without being forced, I enter into reunification services with Ascend Family Institute, LLC. I will keep my provider fully up to date about any changes in my feelings, thoughts, and behaviors. When difficulties arise I will let my provider know so that we can address them in an honest and direct manor. I understand the basic goals and methods of reunification services and that my provider may use different methods of helping me and my family and/or minor child based on the unique factors associated with the presented needs. I have no important questions or concerns that the provider has not discussed with me. I understand that reaching the agreed upon therapeutic goal(s) is not guaranteed and that reunification services has varying levels of effectiveness for different individuals. I also understand that my therapeutic goal(s) may evolve and change based on new insights and/or changes to my life situation. YOUR SIGNATURE BELOW INDICATES THAT YOU HAVE READ THIS AGREEMENT AND AGREE TO ITS TERMS IN ENTIRETY AND ALSO SERVES AS AN ACKNOWLEDGEMENT THAT INCLUDES THE HIPAA NOTICE FORM AND THE PATIENT XXXX OF RIGHTS. YOUR SIGNATURE ALSO INDICATES YOUR BELIEF THAT YOU UNDERSTAND THE SERVICES BEING PROVIDED AND HAVE NO IMPORTANT QUESTIONS THAT HAVE NOT BEEN SUFFICEINTLY ADDRESSED BY THE PROVIDER(S).
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Getting Started. Parents We look forward to supplying you with electricity. The price for electricity is regulated in the Kingdom of Tonga. Please call us if you would like to know current prices. When you move in to your premises you must promptly register with us to establish a supply agreement and comply with our requirements for supply. If your premises have been disconnected or it is a new connection you will also need to register with us to establish a supply agreement. Once you have complied with our requirements we will arrange for the connection of your electricity supply as soon as possible after the commencement of the agreement. There may be a service fee applicable for establishing your account and for a new connection. You will only be liable for charges from the date the agreement commences or your occupancy or tenancy of the premises unless another date has been agreed. You have the option of requesting introductory sessions rights, obligations and responsibilities set out in this agreement which include paying us for the services that we provide you. You will be taken to have understood and agreed to be bound by this agreement either by registering with us before contracting over the phone, in writing, by registering in person, or by using the electricity we supply to you and subsequently agreeing by word or conduct with this agreement. For a residential supply, more than one person may wish to be named as our customer. You may, for servicesinstance, be a couple or a group of flatmates. These introductory sessions are billed at our regular hourly rates reflected earlier In this case, each person who is named on the account has all of the rights, obligations and responsibilities set out in this document for each provider agreement. You may not assign any rights, obligations or responsibilities set out in attendance, and allow the parents to meet us and to ask any questions they may have about the process. Once it is agreed upon that we will be working with your family as reunification providers, this agreement must to any other person. If you are not the owner of the premises to be signedsupplied with electricity you agree to obtain the owner’s or landlord’s consent before the installation of any fittings or meters. The parties make an initial deposit If you are the landlord of $5,000.00the premises and also the account holder, you are fully responsible for your tenant’s outstanding electricity xxxx payments. We strongly recommend you consider this if you are setting a bond with the tenant. Connecting to our network When connecting to our network as a new customer, you and your certified electrical contractor have to complete the TPL New Connection Application Form which requires you to supply us your personal information, load requirements etc. At this stage, your licensed contractor will secure our beginning work together. The initial depositalso be required to apply to obtain a Permit to carry out electrical works, the signed agreement, and a copy of which is also to be supplied to TPL along with the TPL application. The TPL Planning & Design Team will then review both application forms, survey your premises/site and provide you with a detailed estimation of all the materials, labour and transportation costs for supply of power to be paid by you. At that stage, you will also be required to pay a Bond in advance to cover any court orders requiring reunification process must costs that you may have to pay at the end of the customer contract to cover any damages to TPL property or unpaid electricity charges. Upon completion, TPL will be received prior issued with a Certificate of Compliance stating that the house has been wired in accordance with Wiring Bylaws. Once the full payment and the Certificate of Compliance are received, TPL field staff will connect your power supply. Protecting your personal information To enable us to scheduling or holding supply you with electricity and other services and for safety and credit reasons, we need personal information from you. It’s important that you ensure this information is correct, as is any additional appointments. CONSENT FOR SERVICES P1: P2: _ I have received and understand the Notice of Privacy Policy regarding my privacy rights per federal HIPAA laws. P1: P2: _ P1: P2: _ I have received and understand the Minnesota Client Xxxx of Rights. Consent for Services: With enough knowledgeother information you give us, and without being forcedthat you tell us if any of this information changes. Be assured, I enter into reunification though, that this information is strictly confidential and will be kept secure. We will not give your information to anyone except: if you authorise us to do so; or for the purposes of us offering products or services to you which we believe may be of interest to you; or for credit assessment or debt recovery purposes; or if a reputable market research organisation requires information about you, on our behalf, for the purpose of conducting market research, or contacting you,; or if we are legally obliged to (for example by the Electricity Commission). You authorise us to disclose your information for the purposes listed above. Should you wish to make public comments or statements about the products or services we provide you, or the relationship we have with Ascend Family Instituteyou, LLCwe reserve the right to make such public comments as may be necessary to respond or correct any misconceptions or errors of fact. I will keep my provider fully up If you make any public comments about your account then you agree to date us replying as we think appropriate using the information that we have about any changes in my feelings, thoughts, and behaviorsyour account. When difficulties arise I will let my provider know We may record telephone conversations that we have with you so that we may maintain accurate records of our dealings with you. We may also use taped recordings to train our staff or to monitor the level of service that we are providing to you. Your electricity supply We agree to supply to you your electricity requirements in accordance with this agreement. We will also provide to you metering services, unless we both agree otherwise. We will ensure that the equipment used to provide a supply to you is monitored and maintained in accordance with good industry practice. We do not promise your electricity supply will not be interrupted, as referred to under the heading “Interruption to your electricity supply” in this agreement. In addition, power fluctuations, which are called voltage spikes or dips, can address them in an honest occur which can damage sensitive appliances like computers, televisions, videos, microwaves, cordless phones and direct manorcomputerised appliances. I understand the basic goals and methods of reunification services and that my provider may use different methods of helping me and my family and/or minor child based Voltage spikes or dips happen for many reasons but often are due to: people using arc welders, or equipment with powerful motors like circular saws; running kilns or other high load appliances; lightning strike on the unique factors associated with power lines or transformers; broken or cut power lines or cables, often caused by diggers; trees brushing power lines when swaying in the presented needswind, or debris being blown into power lines; vehicles hitting electricity transmission equipment; power system faults. I We will not be liable for any damage caused by voltage spikes or dips, except as set out under the heading “Loss or damage” in this agreement. You should protect any sensitive appliances you have no important questions from voltage spikes and dips. Power conditioners and surge protectors may help to reduce voltage spikes and dips and can be plugged into appliances or concerns wired into your mains supply. These are available from appliance stores. We recommend that the provider has not discussed with me. I understand that reaching the agreed upon therapeutic goal(s) is not guaranteed and that reunification services has varying levels of effectiveness you purchase insurance cover for different individuals. I also understand that my therapeutic goal(s) may evolve and change based on new insights and/or changes electricity damage to my life situation. YOUR SIGNATURE BELOW INDICATES THAT YOU HAVE READ THIS AGREEMENT AND AGREE TO ITS TERMS IN ENTIRETY AND ALSO SERVES AS AN ACKNOWLEDGEMENT THAT INCLUDES THE HIPAA NOTICE FORM AND THE PATIENT XXXX OF RIGHTS. YOUR SIGNATURE ALSO INDICATES YOUR BELIEF THAT YOU UNDERSTAND THE SERVICES BEING PROVIDED AND HAVE NO IMPORTANT QUESTIONS THAT HAVE NOT BEEN SUFFICEINTLY ADDRESSED BY THE PROVIDER(S)your property.
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Samples: Customer Service Agreement
Getting Started. Parents have the option of requesting introductory sessions with us before contracting for services. These introductory sessions are billed at our regular hourly rates reflected earlier in this document for each provider in attendance, and allow the parents to meet us and to ask any questions they may have about the process. Once it is agreed upon that we will be working with your family as reunification providers, this agreement must be signed. The parties make an initial deposit of $5,000.002,000.00, which will secure our beginning work together. The initial deposit, the signed agreement, and a copy of any court orders requiring reunification process therapy must be received prior to scheduling or holding any additional appointments. CONSENT FOR SERVICES P1: P2: _ I have received and understand Ascend reserves the Notice right to require parents participate in individual services to work on individual therapeutic goals prior to the beginning of Privacy Policy regarding my privacy rights per federal HIPAA lawshigh-conflict family services and/or before the child(ren) come to a first session at Ascend. P1: P2: _ P1: P2: _ I have received and understand the Minnesota Client Xxxx of Rights. Consent for Services: With enough knowledge, and without If one or both parent(s) likely has work to do before being forced, I enter into reunification services with Ascend Family Institute, LLC. I will keep my provider fully up able to date about any changes successfully participate in my feelings, thoughts, and behaviors. When difficulties arise I will let my provider know so that we can address them in an honest and direct manor. I understand the basic goals and methods of reunification services and that my provider may use different methods of helping me and my family and/or minor child based on the unique factors associated a therapeutic process with the presented needsfamily, Ascend will expect this work to be completed prior to the children being introduced into the process. I It should be noted that in MOST high-conflict family therapy scenarios, co-parents have no important questions or concerns that goals to work on before children are involved in the provider has not discussed with me. I understand that reaching the agreed upon therapeutic goal(s) is not guaranteed and that reunification services has varying levels of effectiveness for different individuals. I also understand that my therapeutic goal(s) may evolve and change based on new insights and/or changes to my life situationprocess. YOUR SIGNATURE BELOW INDICATES THAT YOU HAVE READ THIS AGREEMENT AND AGREE TO ITS TERMS IN ENTIRETY AND ALSO SERVES AS AN ACKNOWLEDGEMENT THAT INCLUDES THE HIPAA NOTICE FORM AND THE PATIENT XXXX OF RIGHTS. YOUR SIGNATURE ALSO INDICATES YOUR BELIEF THAT YOU UNDERSTAND THE SERVICES BEING PROVIDED AND HAVE NO IMPORTANT QUESTIONS THAT HAVE NOT BEEN SUFFICEINTLY ADDRESSED BY THE PROVIDER(S).. ACCEPTANCE AND SIGNATURES PARENT 1 SIGNATURE I have received and read a copy of the High-Conflict Family Therapy/Services Agreement, and I have addressed any questions I have about the process or payment. I agree to proceed with reunification services at Ascend Family Institute, LLC and consent to the participation my children named here: _ in this reunification process as well. I agree to pay Ascend Family Institute $ of the $2,000.00 initial deposit. Parent’s Signature: Date:_ Print Parent Name: _ _ PARENT 2 SIGNATURE I have received and read a copy of the High-Conflict Family Therapy/Services Agreement, and I have addressed any questions I have about the process or payment. I agree to proceed with reunification services at Ascend Family Institute, LLC and consent to the participation my children named here: _ in this reunification process as well. I agree to pay Ascend Family Institute $ of the $2,000.00 initial deposit. Parent’s Signature: Date:_
Appears in 1 contract
Samples: Services Agreement
Getting Started. Parents have the option of requesting introductory sessions with us before contracting for services. These introductory sessions are billed at our regular hourly rates reflected earlier in this document for each provider in attendance, and allow the parents to meet us and to ask any questions they may have about the process. Once it is agreed upon that we will be working with your family as reunification providers, this agreement must be signed. The parties make an initial deposit of $5,000.00$ , which will secure our beginning work together. The initial deposit, the signed agreement, and a copy of any court orders requiring reunification process therapy must be received prior to scheduling or holding any additional appointments. CONSENT FOR SERVICES P1: P2: _ I have received and understand the Notice of Privacy Policy regarding my privacy rights per federal HIPAA laws. P1: P2: _ P1: P2: _ I have received and understand the Minnesota Client Xxxx of Rights. Consent for Services: With enough knowledge, and without being forced, I enter into reunification services with Ascend Family Institute, LLC. I will keep my provider fully up to date about any changes in my feelings, thoughts, and behaviors. When difficulties arise I will let my provider know so that we can address them in an honest and direct manor. I understand the basic goals and methods of reunification services and that my provider may use different methods of helping me and my family and/or minor child based on the unique factors associated with the presented needs. I have no important questions or concerns that the provider has not discussed with me. I understand that reaching the agreed upon therapeutic goal(s) is not guaranteed and that reunification services has varying levels of effectiveness for different individuals. I also understand that my therapeutic goal(s) may evolve and change based on new insights and/or changes to my life situation. YOUR SIGNATURE BELOW INDICATES THAT YOU HAVE READ THIS AGREEMENT AND AGREE TO ITS TERMS IN ENTIRETY AND ALSO SERVES AS AN ACKNOWLEDGEMENT THAT INCLUDES THE HIPAA NOTICE FORM AND THE PATIENT XXXX OF RIGHTS. YOUR SIGNATURE ALSO INDICATES YOUR BELIEF THAT YOU UNDERSTAND THE SERVICES BEING PROVIDED AND HAVE NO IMPORTANT QUESTIONS THAT HAVE NOT BEEN SUFFICEINTLY ADDRESSED BY THE PROVIDER(S).. ACCEPTANCE AND SIGNATURES PARENT SIGNATURE I have received and read a copy of the High-Conflict Services Agreement, and I have addressed any questions I have about the process or payment. I agree to proceed with services at Ascend Family Institute, LLC and consent to the participation my children named here: in this process as well. I agree to pay Ascend Family Institute $ of the $ initial deposit. Parent’s Signature: Date: Print Parent Name: PARENT SIGNATURE I have received and read a copy of the High-Conflict Services Agreement, and I have addressed any questions I have about the process or payment. I agree to proceed with services at Ascend Family Institute, LLC and consent to the participation my children named here: in this process as well. I agree to pay Ascend Family Institute $ of the $ initial deposit. Parent’s Signature: Date:
Appears in 1 contract
Samples: Services Agreement
Getting Started. Parents have the option of requesting introductory sessions with us before contracting for services. These introductory sessions are billed at our regular hourly rates reflected earlier in this document for each provider in attendance, and allow the parents to meet us and to ask any questions they may have about the process. Once it is agreed upon that we will be working with your family as reunification providers, this agreement must be signed. The parties make an initial deposit of $5,000.002,000.00, which will secure our beginning work together. The initial deposit, the signed agreement, and a copy of any court orders requiring reunification process therapy must be received prior to scheduling or holding any additional appointments. CONSENT FOR SERVICES P1: P2: _ I have received and understand Ascend reserves the Notice right to require parents participate in individual services to work on individual therapeutic goals prior to the beginning of Privacy Policy regarding my privacy rights per federal HIPAA lawshigh-conflict family services and/or before the child(ren) come to a first session at Ascend. P1: P2: _ P1: P2: _ I have received and understand the Minnesota Client Xxxx of Rights. Consent for Services: With enough knowledge, and without If one or both parent(s) likely has work to do before being forced, I enter into reunification services with Ascend Family Institute, LLC. I will keep my provider fully up able to date about any changes successfully participate in my feelings, thoughts, and behaviors. When difficulties arise I will let my provider know so that we can address them in an honest and direct manor. I understand the basic goals and methods of reunification services and that my provider may use different methods of helping me and my family and/or minor child based on the unique factors associated a therapeutic process with the presented needsfamily, Ascend will expect this work to be completed prior to the children being introduced into the process. I It should be noted that in MOST high-conflict family therapy scenarios, co-parents have no important questions or concerns that goals to work on before children are involved in the provider has not discussed with me. I understand that reaching the agreed upon therapeutic goal(s) is not guaranteed and that reunification services has varying levels of effectiveness for different individuals. I also understand that my therapeutic goal(s) may evolve and change based on new insights and/or changes to my life situationprocess. YOUR SIGNATURE BELOW INDICATES THAT YOU HAVE READ THIS AGREEMENT AND AGREE TO ITS TERMS IN ENTIRETY AND ALSO SERVES AS AN ACKNOWLEDGEMENT THAT INCLUDES THE HIPAA NOTICE FORM AND THE PATIENT XXXX BILL OF RIGHTS. YOUR SIGNATURE ALSO INDICATES YOUR BELIEF THAT YOU UNDERSTAND THE SERVICES BEING PROVIDED AND HAVE NO IMPORTANT QUESTIONS THAT HAVE NOT BEEN SUFFICEINTLY ADDRESSED BY THE PROVIDER(S).. ACCEPTANCE AND SIGNATURES PARENT 1 SIGNATURE I have received and read a copy of the High-Conflict Family Therapy/Services Agreement, and I have addressed any questions I have about the process or payment. I agree to proceed with reunification services at Ascend Family Institute, LLC and consent to the participation my children named here: _ in this reunification process as well. I agree to pay Ascend Family Institute $ of the $2,000.00 initial deposit. Parent’s Signature: Date:_ Print Parent Name: _ _ PARENT 2 SIGNATURE I have received and read a copy of the High-Conflict Family Therapy/Services Agreement, and I have addressed any questions I have about the process or payment. I agree to proceed with reunification services at Ascend Family Institute, LLC and consent to the participation my children named here: _ in this reunification process as well. I agree to pay Ascend Family Institute $ of the $2,000.00 initial deposit. Parent’s Signature: Date:_
Appears in 1 contract
Samples: Services Agreement
Getting Started. Parents have the option of requesting introductory sessions with us before contracting for services. These introductory sessions are billed at our regular hourly rates reflected earlier in this document for each provider in attendance, and allow the parents to meet us and to ask any questions they may have about the process. Once it is agreed upon that we will be working with your family as reunification providers, this agreement must be signed. The parties make an initial deposit of $5,000.00$ , which will secure our beginning work together. The initial deposit, the signed agreement, and a copy of any court orders requiring reunification process therapy must be received prior to scheduling or holding any additional appointments. CONSENT FOR SERVICES P1: P2: _ I have received and understand the Notice of Privacy Policy regarding my privacy rights per federal HIPAA laws. P1: P2: _ P1: P2: _ I have received and understand the Minnesota Client Xxxx of Rights. Consent for Services: With enough knowledge, and without being forced, I enter into reunification services with Ascend Family Institute, LLC. I will keep my provider fully up to date about any changes in my feelings, thoughts, and behaviors. When difficulties arise I will let my provider know so that we can address them in an honest and direct manor. I understand the basic goals and methods of reunification services and that my provider may use different methods of helping me and my family and/or minor child based on the unique factors associated with the presented needs. I have no important questions or concerns that the provider has not discussed with me. I understand that reaching the agreed upon therapeutic goal(s) is not guaranteed and that reunification services has varying levels of effectiveness for different individuals. I also understand that my therapeutic goal(s) may evolve and change based on new insights and/or changes to my life situation. YOUR SIGNATURE BELOW INDICATES THAT YOU HAVE READ THIS AGREEMENT AND AGREE TO ITS TERMS IN ENTIRETY AND ALSO SERVES AS AN ACKNOWLEDGEMENT THAT INCLUDES THE HIPAA NOTICE FORM AND THE PATIENT XXXX BILL OF RIGHTS. YOUR SIGNATURE ALSO INDICATES YOUR BELIEF THAT YOU UNDERSTAND THE SERVICES BEING PROVIDED AND HAVE NO IMPORTANT QUESTIONS THAT HAVE NOT BEEN SUFFICEINTLY ADDRESSED BY THE PROVIDER(S).. ACCEPTANCE AND SIGNATURES PARENT SIGNATURE I have received and read a copy of the High-Conflict Services Agreement, and I have addressed any questions I have about the process or payment. I agree to proceed with services at Ascend Family Institute, LLC and consent to the participation my children named here: in this process as well. I agree to pay Ascend Family Institute $ of the $ initial deposit. Parent’s Signature: Date: Print Parent Name: PARENT SIGNATURE I have received and read a copy of the High-Conflict Services Agreement, and I have addressed any questions I have about the process or payment. I agree to proceed with services at Ascend Family Institute, LLC and consent to the participation my children named here: in this process as well. I agree to pay Ascend Family Institute $ of the $ initial deposit. Parent’s Signature: Date:
Appears in 1 contract
Samples: Services Agreement
Getting Started. Parents have the option of requesting introductory sessions with us before contracting for services. These introductory sessions are billed at our regular hourly rates reflected earlier in this document for each provider in attendance, and allow the parents to meet us and to ask any questions they may have about the process. Once it is agreed upon that we will be working with your family as reunification providers, this agreement must be signed. The parties make an initial deposit of $5,000.00, which will secure our beginning work together. The initial deposit, the signed agreement, and a copy of any court orders requiring reunification process must be received prior to scheduling or holding any additional appointments. CONSENT FOR SERVICES P1: P2: _ I have received and understand the Notice of Privacy Policy regarding my privacy rights per federal HIPAA laws. P1: P2: _ P1: P2: _ I have received and understand the Minnesota Client Xxxx Bill of Rights. Consent for Services: With enough knowledge, and without being forced, I enter into reunification services with Ascend Family Institute, LLC. I will keep my provider fully up to date about any changes in my feelings, thoughts, and behaviors. When difficulties arise I will let my provider know so that we can address them in an honest and direct manor. I understand the basic goals and methods of reunification services and that my provider may use different methods of helping me and my family and/or minor child based on the unique factors associated with the presented needs. I have no important questions or concerns that the provider has not discussed with me. I understand that reaching the agreed upon therapeutic goal(s) is not guaranteed and that reunification services has varying levels of effectiveness for different individuals. I also understand that my therapeutic goal(s) may evolve and change based on new insights and/or changes to my life situation. YOUR SIGNATURE BELOW INDICATES THAT YOU HAVE READ THIS AGREEMENT AND AGREE TO ITS TERMS IN ENTIRETY AND ALSO SERVES AS AN ACKNOWLEDGEMENT THAT INCLUDES THE HIPAA NOTICE FORM AND THE PATIENT XXXX BILL OF RIGHTS. YOUR SIGNATURE ALSO INDICATES YOUR BELIEF THAT YOU UNDERSTAND THE SERVICES BEING PROVIDED AND HAVE NO IMPORTANT QUESTIONS THAT HAVE NOT BEEN SUFFICEINTLY ADDRESSED BY THE PROVIDER(S).
Appears in 1 contract
