AGREEMENT FOR SERVICE/INFORMED CONSENT: MINORTherapy Contract • September 29th, 2020
Welcome! It is a pleasure to have you as a Client. We strive to make sure your treatment will be as therapeutically productive as possible. The specifics of the treatment goals and the steps to achieve these goals will be discussed at the Intake Appointment. Your participation and understanding of the treatment goals is essential for the best benefit of therapy.
AGREEMENT FOR SERVICE/INFORMED CONSENT: ADULTTherapy Contract • November 5th, 2021
Welcome! It is a pleasure to have you as a Client. We strive to make sure your treatment will be as therapeutically productive as possible. The specifics of the treatment goals and the steps to achieve these goals will be discussed at the Intake Appointment. Your participation and understanding of the treatment goals is essential for the best benefit of therapy.
Therapy contractTherapy Contract • March 26th, 2024
and Institutsambulanz des DGVT Aus- und Weiterbildungszentrums Erlangen-Nürnberg GmbH represented by the Institute Management
Therapy ContractTherapy Contract • September 13th, 2021
Aim of Therapy: The aim of therapy is to provide you, the client with a confidential opportunity to explore personal and relational issues in safety. My role, as the therapist is to help you through this process without judgement or telling you what to do. I will however give information or offer suggestions. During therapy, we set goals to work towards as agreed between the client and the therapist. If at any time I feel I can no longer help you I will offer to recommend you to someone who can.
THERAPY CONTRACT, POLICIES & FINANCIAL AGREEMENTTherapy Contract • August 12th, 2018
I, , hereby give my full consent for my child, , or myself, to receive speech and language therapy and treatment provided by Lori A. Gross, Speech and Language Pathol- ogist, until I notify Ms. Gross of any changes or until Ms. Gross determines that services are no longer necessary. If I am referring my child for services, I certify that I have legal responsibility for this child and am authorized to seek treatment for him or her.
THERAPY CONTRACT: TERMS AND CONDITIONS 2022Therapy Contract • September 20th, 2022
Being a client at this practice signifies that you, (the client or legal guardians of the client) are subject to comply with the following, during the period of intervention:
Therapy contractTherapy Contract • April 11th, 2023
and Institutsambulanz des DGVT Aus- und Weiterbildungszentrums Erlangen-Nürnberg GmbH represented by the Institute Management
THERAPY CONTRACTTherapy Contract • October 7th, 2022
Please read document this carefully before using services by K D Peak therapy and sign this contract only if you wish to be bound by it.
