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Anthony Purview, LEFT Licensed Marriage and Family Therapist 302 S. Claiborne Rd, Suite B Olathe, KS 66062 Tel: 9137300727 Anthony puryearcounseling.com www.puryearcounseling.com KS LIC# 2612MINOR
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How to fill out puryear counseling minor consent
How to fill out puryear counseling minor consent
01
Obtain a copy of the Puryear Counseling Minor Consent form from the counselor or the official website.
02
Read the instructions and information on the form carefully.
03
Fill out the minor's personal information, such as name, date of birth, and address.
04
Provide information about the minor's parents or legal guardians, including their names and contact details.
05
Specify the reason for seeking counseling services for the minor.
06
Indicate any known medical or mental health conditions or medications the minor is currently taking.
07
Sign and date the consent form as the parent or legal guardian, acknowledging that you understand and consent to the minor receiving counseling services.
08
Make a copy of the completed consent form for your records.
09
Submit the signed consent form to the counselor or the appropriate counseling center.
Who needs puryear counseling minor consent?
01
Parents or legal guardians of minors who wish to have their children receive counseling services from Puryear Counseling need to fill out the Puryear Counseling Minor Consent form.
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What is puryear counseling minor consent?
Puryear counseling minor consent is a legal document that allows a minor to receive counseling services without parental consent.
Who is required to file puryear counseling minor consent?
Minors seeking counseling services without parental consent are required to file puryear counseling minor consent.
How to fill out puryear counseling minor consent?
Puryear counseling minor consent can be filled out by the minor with assistance from the counseling provider.
What is the purpose of puryear counseling minor consent?
The purpose of puryear counseling minor consent is to protect the confidentiality of the minor seeking counseling services.
What information must be reported on puryear counseling minor consent?
Puryear counseling minor consent must include the name of the minor, the type of counseling services being received, and the signatures of the minor and counseling provider.
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