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1. Parties: Identification of the therapist/practice and client, including licensing and registration details of the therapist
2. Background: Brief context about the therapeutic relationship and purpose of the document
3. Definitions: Key terms used in the document including 'therapy', 'confidentiality', 'session', etc.
4. Consent to Treatment: Express acknowledgment and agreement to receive therapeutic services
5. Nature of Services: Description of therapy services, approach, and methods to be used
6. Confidentiality: Details about privacy policies and limits of confidentiality
7. Rights and Responsibilities: Outline of both therapist's and client's rights and responsibilities
8. Emergency Procedures: Protocol for emergencies and crisis situations
9. Fee Structure: Information about fees, payment methods, and cancellation policies
10. Release of Liability: Specific terms releasing therapist from certain liabilities
11. Signature and Date: Space for formal execution of the document
1. Telehealth Services: Include when offering online or remote therapy sessions
2. Group Therapy Provisions: Include when client may participate in group therapy sessions
3. Recording Consent: Include if sessions may be recorded for training or supervision purposes
4. Insurance and Billing: Include when working with insurance providers
5. Research Participation: Include if client data may be used for research purposes
6. Minor Client Provisions: Include when working with clients under 18 years of age
1. Fee Schedule: Detailed breakdown of all applicable fees and payment terms
2. Emergency Contact Form: Client's emergency contact information and authorized contacts
3. Specific Consent Forms: Additional consent forms for specific therapeutic techniques or approaches
4. Privacy Policy: Detailed privacy and data protection policies
5. Complaint Procedure: Formal procedure for raising and addressing complaints
Therapist
Client
Therapeutic Relationship
Informed Consent
Confidentiality
Protected Health Information
Treatment Plan
Session
Clinical Records
Emergency Contact
Crisis Situation
Professional Services
Clinical Hour
Termination
Duty of Care
Force Majeure
Privileged Communication
Mental Health Emergency
Reasonable Care
Professional Boundaries
Therapeutic Goals
Release of Information
Liability
Negligence
Consultation
Referral
Medical Records
Privacy Breach
Cancellation Policy
No-Show
Payment Terms
Confidential Communication
Clinical Assessment
Treatment Modality
Confidentiality
Privacy
Liability
Payment Terms
Termination
Emergency Procedures
Professional Services
Record Keeping
Rights and Responsibilities
Data Protection
Force Majeure
Dispute Resolution
Governing Law
Insurance
Communication
Crisis Management
Referral Process
Scheduling
Electronic Communications
Session Recording
Medical Records Access
Professional Boundaries
Quality of Service
Healthcare
Mental Health Services
Medical Services
Education
Corporate Wellness
Insurance
Social Services
Non-Profit Organizations
Employee Assistance Programs
Rehabilitation Services
Legal
Compliance
Risk Management
Medical Records
Administrative
Clinical Operations
Quality Assurance
Patient Services
Insurance Coordination
Professional Standards
Psychologist
Psychiatrist
Mental Health Counselor
Clinical Social Worker
Marriage and Family Therapist
Rehabilitation Counselor
School Counselor
Healthcare Administrator
Medical Director
Legal Compliance Officer
Risk Management Officer
Insurance Coordinator
Medical Records Manager
Practice Manager
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