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Mary Kroger, Ph.D.
Christian Psychological ServicesAGREEMENT FOR PSYCHOLOGICAL SERVICES AND
CONSENT FOR TREATMENT
Thank you for choosing me for your counseling needs. I am committed to giving you
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How to fill out agreement for psychological services
How to fill out agreement for psychological services
01
Read the agreement thoroughly before filling it out.
02
Fill in your personal information accurately, including your name, address, and contact details.
03
Specify the purpose of the agreement and the type of psychological services being agreed upon.
04
Include any terms and conditions related to the services, such as the duration, frequency, and fees.
05
Define the responsibilities of both parties involved in the agreement, including the psychologist and the client.
06
Clearly state the confidentiality and privacy policies.
07
Provide a section for the client to acknowledge their understanding and agreement to the terms.
08
Have both parties sign and date the agreement.
09
Make copies of the agreement for each party to retain.
10
Ensure that all parties have a copy of the signed agreement for future reference.
Who needs agreement for psychological services?
01
Individuals seeking psychological counseling or therapy services.
02
Couples seeking couples therapy or marriage counseling.
03
Families seeking family therapy or support.
04
Organizations or businesses referring employees for psychological services.
05
Schools or educational institutions requiring psychological assessments or interventions for students.
06
Legal entities seeking psychological evaluations or expert opinions for court purposes.
07
Anyone desiring psychological support, guidance, or assessment for personal or professional reasons.
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