As a client, you have the right to be informed about your condition and any recommended therapeutic, psychological, or diagnostic procedures. This knowledge allows you to make an informed decision about whether to proceed with the suggested course of action, understanding the associated risks and benefits. At this stage, no specific treatment plan has been proposed. This form is to obtain your consent for the evaluations necessary to determine the appropriate treatment and/or procedures for any identified conditions.
Consent for Therapeutic Evaluations
By signing this form, you grant us permission to conduct reasonable and necessary assessments, tests, and treatments. Specifically, your signature indicates that:
- This consent is ongoing, even after a diagnosis has been made and treatment recommended.
- You agree to receive treatment at this office or any affiliated satellite office under common ownership.
This consent remains valid until you revoke it in writing. You reserve the right to discontinue services at any time.
Discussion of Treatment Plan
You have the opportunity to discuss any treatment plan with your counselor, therapist, or psychiatrist, including the purpose, potential risks, and benefits of any tests or treatments recommended. If you have concerns or questions about any suggestions made by your mental health provider, we encourage you to ask for clarification.
Request for Mental Health Services
I voluntarily request that a counselor, therapist, psychiatrist, or any other relevant mental health professional, conduct reasonable and necessary assessments, tests, and treatments for the condition for which I am seeking care at this practice. I understand that if additional assessments, invasive procedures, or specialized interventions are recommended, I will be asked to read and sign additional consent forms before proceeding with these actions.
