Purpose of Testing. In the interest of maintaining a safe and productive working environment for all City employees, establishing a standard of conduct for City employees, protecting the public health, safety, and welfare, upholding the public confidence in the work performed by City employees, and upholding the organizational image/reputation of the City, the Employer and the Union hereby agree that employee drug and alcohol testing should be addressed within this Agreement. In that regard, the purpose of this Article is to establish the terms, conditions and procedures regarding the drug and alcohol testing of bargaining unit members.
Purpose of Testing. I understand that the purpose of this evaluation is to : __________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ The length of time between will vary with each client. The procedures for selecting, giving and scoring the tests, interpreting and storing the results, and maintain the privacy of the test results will be carried out in accordance with the guidelines of the American Psychological Association. The tests will be chosen based on the suitability for the purposes aforementioned. These tests will be given and score according to the instructions in the tests’ manuals, so that valid scores will be obtained. These scores will be interpreted according to scientific finding and guidelines from the scientific and professional literature. The raw data, test results and report will be kept in a locked filing cabinet. I understand that the fee for this (these) service(s) will be $____________. Payment for these services will be as follows: Bill my insurance company directly for these services. I agree to pay any deductibles, co-payments or other balance in accordance with my health insurance policy and in accordance with the contract (if any) between the psychologist and the health insurance company, I understand that I am fully responsible for payment these services at the contracted rate established by my health insurance. Pay in full. I understand that I am fully responsible for payment for these services. Set up payment plan with Agave Studio for Psychotherapy and Spiritual Direction. I understand that I am fully responsible for payment of these services. Other: ________________________________________________________________________________ ________________________________________________________________________________________ I agree to help as much as I can, by supplying full answers, making an honest effort, and working as best I can to make sure that the findings are accurate. ____________________________________________ Signature of client Date ____________________________________________ If minor, signature of parent/guardian Date I, the psychologist, have discussed the issue above with the client (and/or his or her parent or guardian). My observations of this person’s behavior and responses give me no reason, in my professional judgment, to believe that this person is not full...
Purpose of Testing. I understand that the purpose of this evaluation is to : The length of time between will vary with each client. The procedures for selecting, giving and scoring the tests, interpreting and storing the results, and maintain the privacy of the test results will be carried out in accordance with the guidelines of the American Psychological Association. The tests will be chosen based on the suitability for the purposes aforementioned. These tests will be given and score according to the instructions in the tests’ manuals, so that valid scores will be obtained. These scores will be interpreted according to scientific finding and guidelines from the scientific and professional literature. Agave Studio for Psychotherapy & Spiritual Direction 0000 Xxxx Xxxxxxx Xxx. #000 Chicago, IL 60622 The raw data, test results and report will be kept in a locked filing cabinet. I understand that the fee for this (these) service(s) will be $ . Payment for these services will be as follows: ú Bill my insurance company directly for these services. I agree to pay any deductibles, co-‐payments or other balance in accordance with my health insurance policy and in accordance with the contract (if any) between the psychologist and the health insurance company, I understand that I am fully responsible for payment these services at the contracted rate established by my health insurance. ú Pay in full. I understand that I am fully responsible for payment for these services. ú Set up payment plan with Agave Studio for Psychotherapy and Spiritual Direction. I understand that I am fully responsible for payment of these services. ú Other: I agree to help as much as I can, by supplying full answers, making an honest effort, and working as best I can to make sure that the findings are accurate. Signature of client Date If minor, signature of parent/guardian Date I, the psychologist, have discussed the issue above with the client (and/or his or her parent or guardian). My observations of this person’s behavior and responses give me no reason, in my professional judgment, to believe that this person is not fully competent to give informed and willing consent. Signature of practicum student/ Date psychologist
