Unformatted text preview: there, as shown by my signature below and on the brochure. Signature of client (or person acting for client) Date Printed name I, the therapist, have discussed the issues above with the client (and/or the person acting for the client). My obser-vations of the person’s behavior and responses give me no reason to believe that this person is not fully competent to give informed and willing consent. Signature of therapist Date q Copy accepted by client q Copy kept by therapist FORM 29. Agreement to pay for professional services. From The Paper Office . Copyright 2008 by Edward L. Zuckerman. Permission to photocopy this form is granted to purchasers of this book for personal use only (see copyright page for details)....
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- Spring '10
- Payment, person, therapist, professional services