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CLIENTCLINICIAN AGREEMENT 8120 Piedmont Ave Suite 205 Bethesda, MD 20814 MD License #:16067Keith A. Miller MSW, LCSW, LCSWC1320 19th Street, NW Suite 200 Washington, DC 20036 DC License #: LC50078281CONFIDENTIALITY:

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How to fill out client-clinician agreement - keith

01

To fill out a client-clinician agreement, follow these steps:

02

Gather all necessary documents: Make sure you have the latest version of the client-clinician agreement form.

03

Review the agreement: Read the entire agreement carefully to understand the terms and conditions.

04

Fill in personal details: Provide your name, address, contact information, and any necessary identification numbers.

05

Specify the clinician: Indicate the name and contact details of the clinician you will be working with.

06

Agree to terms: Read through the agreement clauses and indicate your acceptance by signing and dating the document.

07

Seek clarification: If you have any questions or need clarification on any sections, reach out to your clinician or legal advisor.

08

Keep a copy: Make a copy of the filled-out agreement for your records and provide the original to your clinician.

09

Periodically review: Review the agreement periodically to ensure it remains up to date and relevant to your ongoing therapy sessions.

Who needs client-clinician agreement - keith?

01

Anyone who engages in therapy or counseling services with a clinician needs a client-clinician agreement. This agreement helps establish the rights, responsibilities, and mutual expectations between the client and the clinician. It ensures clarity on matters such as confidentiality, payment terms, session schedules, and termination policies. Having a client-clinician agreement protects both the client and the clinician and promotes a professional working relationship. It is a standard practice in the mental health field and is beneficial for both parties involved.

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