AGREEMENT FOR PSYCHOTHERAPY SERVICES/INFORMED CONSENTAgreement for Psychotherapy Services • February 2nd, 2022
This document contains important information about my professional services and business policies. Although these documents are long and sometimes complex, it is very important that you read them carefully. When you sign this document, it will also represent an agreement between us and become a part of your medical record. You may revoke this Agreement in writing at any time. That revocation will be binding for me unless we have taken action in reliance on it; if there are obligations imposed on me by your health insurer in order to process or substantiate claims made under your policy; or if you have not satisfied any financial obligations you have incurred.