SUMMARY. If you have questions about therapy, my procedures, or your role in this process, please discuss them with me. Remember that the best way to assure quality and ethical treatment is to keep communication open and direct with your clinician. By signing below you indicate that your have read and understood this document.
Appears in 8 contracts
Samples: Outpatient Services Agreement, Outpatient Services Agreement, Outpatient Services Agreement
SUMMARY. If you have questions about therapy, my procedures, or your role in this process, please discuss them with me. Remember that the best way to assure quality and ethical treatment is to keep communication open and direct with your clinician. By signing below below, you indicate that your have read and understood this document.. Signature Date
Appears in 2 contracts
SUMMARY. If you have questions about therapy, my procedures, or your role in this process, please discuss them with me. Remember that the best way to assure quality and ethical treatment is to keep communication open and direct with your clinician. By signing below you indicate that your have read and understood this document.. Signature Date
Appears in 2 contracts
Samples: Counseling and Psychological Services Agreement, drsherribornstein.com
SUMMARY. If you have questions about therapy, my procedures, or your role in this process, please discuss them with me. Remember that the best way to assure quality and ethical treatment is to keep communication open and direct with your clinician. By signing below you You indicate that your have read and understood this document.document by signing below. Signature Date
Appears in 1 contract
Samples: www.drstevenmeyers.com
SUMMARY. If you have questions about therapy, my procedures, or your role in this process, please discuss them with me. Remember that the best way to assure quality and ethical treatment is to keep communication open and direct with your clinician. By signing below you indicate that your you have read and understood this document.. Print Client’s Name Your Relationship To The Client Print Your Name
Appears in 1 contract
Samples: drdgattis.com
SUMMARY. If you have questions about therapy, my procedures, or your role in this process, please discuss them with me. Remember that the best way to assure quality and ethical treatment is to keep communication open and direct with your clinician. By signing Your signature below indicates that you indicate that your have read the information in this document and understood this documentagree to abide by its terms during our professional relationship.
Appears in 1 contract
Samples: empoweredbehavioralhealth.com
SUMMARY. If you have questions about therapy, my procedures, or your role in this process, please discuss them with methe clinician. Remember that the best way to assure quality and ethical treatment is to keep communication open and direct with your cliniciandirect. By signing below you indicate that your have read and understood this document.the forms checklist under ‘Informed Consent for
Appears in 1 contract
Samples: Centre Psychology Group
SUMMARY. If you have questions about therapy, my procedures, or your role in this process, please discuss them with me. Remember that the best way to assure quality and ethical treatment is to keep communication open and direct with your cliniciantherapist. By signing below you indicate that your have read and understood this document.
Appears in 1 contract
Samples: Services Agreement
SUMMARY. If you have questions about therapy, my procedures, or your role in this process, please discuss them with me. Remember that the best way to assure quality and ethical treatment is to keep communication open and direct with your clinician. By signing below below, you indicate that your you have read and understood this document.. Patient/ Client Signature Date
Appears in 1 contract
Samples: chabeliado.com
SUMMARY. If you have questions about therapy, my procedures, or your role in this process, please discuss them with me. Remember that the best way to assure quality and ethical treatment is to keep communication open and direct with your clinician. By signing below below, you indicate that your you have read and understood this document.. Print Name Date
Appears in 1 contract
Samples: Outpatient Services Agreement
SUMMARY. If you have questions about therapy, my procedures, or your role in this process, please discuss them with me. Remember that the best way to assure quality and ethical treatment is to keep communication open and direct with your clinician. By signing below you indicate that your have read and understood this document.. _____________________________________ ____________________
Appears in 1 contract
Samples: childpsychaz.com
SUMMARY. If you have questions about therapy, my procedures, or your role in this process, please discuss them with me. Remember that the best way to assure quality and ethical treatment is to keep communication open and direct with your clinician. By signing below below, you indicate that your have read and understood this document.
Appears in 1 contract
Samples: Outpatient Services Agreement