Forms
Please confirm which form you will need to complete by contacting Piekenbrock Psychological Services directly.
2. Informed Consent for Telepsychology
This Informed Consent for Telepsychology contains important information focusing on doing psychotherapy using the phone or the Internet. Please read this carefully, and let me know if you have any questions. When you sign this document, it will represent an agreement between us.
4. Informed Consent for Psychotherapist Adult Client Contract
This document contains important information about my professional services and business policies. Please read it carefully and jot down any questions you might have so that we can discuss them at our next meeting. When you sign this document, it will represent an agreement between us.
5. Informed Consent for Psychotherapist Minor Client Contract
This document allows the clinician to clarify whether parents have agreed to the structure proposed in the treatment contract and will assist in the discussion with the child or teen regarding the parameters of confidentiality, information sharing, and records access.
6. Informed Consent Client Services Agreement for Collaterals
I want to thank you for accepting the invitation to assist in [Insert Patient’s name] psychotherapeutic treatment. Your participation is important and is sometimes essential to the success of the treatment. This document is to inform you about the risks, rights and responsibilities of your participation as a collateral participant.