I ask that you review, and sign this document where shown. Successful therapy requires a commitment by both the therapist and the client.
The following policies have been established for my private practice.
Please sign at the bottom showing that you agree, acknowledge, and/or understand:
As a mental health therapist, I need to have legal documentation of child custody before I can provide services to a potential client who is a minor. This is to ensure that I have the proper consent from the parent or guardian who has the legal authority to make decisions about the child's health care. Legal documentation of child custody can include a court order, a divorce decree, or a written agreement between the parents.