Common Contracts
1 similar Therapy Participation Agreement contracts
ContractTherapy Participation Agreement • February 26th, 2013
Therapy Participation AgreementChild’s Name DOB: We are committed to partnering with you to optimize the benefits of therapy for your child. We have outlined below the key factors we believe most contribute to your child meeting their goals. What is our role in your child’s success? W hat is your role in your child’s success? Schedulingo Review scheduling guidelines with you.o Assure scheduled visits follow treatment plan. Schedulingo Follow scheduling guidelines – You may schedule up to four visits over a 2 month period. Preparednesso Assist with insurance authorization and ensure all visits are authorized by the parent.o Ensure that needed equipment and/or suppliesare available at each visit. Preparednesso Understand your insurance benefits and self-pay options.o Bring the equipment and/or supplies your childneeds to each visit. Participationo Start therapy at the scheduled time.o Give you and your child our full attention during each visit.o Learn what motivates or limits your child