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Jade Depue, M.Ed., LPC, NCC JRCounseling.Wellness@gmail.com Office: 5736343424 Fax: 6368980951INFORMED CONSENT FOR TREATMENTI, ___ and ___ agree(Name of Client)(Name of Parent/Guardian) Consent to
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Jade Depue is a licensed professional who provides services related to their specific field of expertise.
Any individual or organization that has received services from Jade Depue may be required to file information about those services.
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Information such as the nature of services provided, dates of service, fees charged, and any other relevant details must be reported on Jade Depue's licensed professional record.
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