AGREEMENT FOR SERVICE/INFORMED CONSENT FOR MINORSAgreement for Service/Informed Consent for Minors • November 15th, 2019
This Agreement has been created for the purpose of outlining the terms and conditions of services for the minor child(ren) [Client name] (herein referred to as “Client”) and is intended to provide [name of parent/legal guardian] (herein referred to as Representative) with important information regarding the practices, policies and procedures of ‘Lorelei O'Neill, Licensed Marriage & Family Professional Corporation (herein referred to as the “Office”), and the Therapist named above (herein referred to as the “Therapist”) and to clarify the terms of the professional therapeutic relationship between the Therapist and the Client. Any questions or concerns regarding the contents of this Agreement should be discussed with the Therapist prior to signing it.
AGREEMENT FOR SERVICE/INFORMED CONSENT FOR MINORSAgreement for Service/Informed Consent for Minors • September 14th, 2013
This Agreement has been created for the purpose of outlining the terms and conditions of services for the minor child(ren) [Client name] (herein referred to as “Client”) and is intended to provide [name of parent/legal guardian] (herein referred to as Representative) with important information regarding the practices, policies and procedures of Life in Progress, Inc. (herein referred to as the “Office”), and the Therapist named above (herein referred to as the “Therapist”) and to clarify the terms of the professional therapeutic relationship between the Therapist and the Client. Any questions or concerns regarding the contents of this Agreement should be discussed with the Therapist prior to signing it.
AGREEMENT FOR SERVICE/INFORMED CONSENT FOR MINORSAgreement for Service/Informed Consent for Minors • September 13th, 2012
This Agreement has been created for the purpose of outlining the terms and conditions of services for the minor child(ren) [Client name] (herein referred to as “Client”) and is intended to provide [name of parent/legal guardian] (herein referred to as Representative) with important information regarding the practices, policies and procedures of Life in Progress, Inc. (herein referred to as the “Office”), and the Therapist named above (herein referred to as the “Therapist”) and to clarify the terms of the professional therapeutic relationship between the Therapist and the Client. Any questions or concerns regarding the contents of this Agreement should be discussed with the Therapist prior to signing it.