Hourly Sessions Agreement

Agreements*

I authorize the Solutions Parenting Support, it’s employee’s and Independent Contractors to email any correspondence regarding my treatment, satisfaction with treatment, updates about my treatment and educational programs during and after the completion of my treatment to my provided email address.
I authorize the Solutions Parenting Support, it’s employee’s and Independent Contractors to collaborate with outside referral sources and outpatient therapists as documented onlyon the release of information form that I provide.

Disclosures*

I understand Solutions Parenting Support, it’s employee’s and Independent Contractors cannot be held responsible for being unable to access me due to telephone devices that may block their calls, my use of a pager system in which I cannot be directly reached, any form of caller identification, or any type of device that does not allow my parent coach to make direct telephone contact with me.

Financials*

The usual and customary rate for providing parent coaching services through Solutions Parenting Support:

Services include parent coaching for 1 hour, scheduled at least 1 week in advance, by video call, phone call or in-person when possible.
$85 per session, to be paid at the time of the session.

Additional Comments and Special Arrangements*

If a payment plan is needed AND agreed upon, the agreed upon payments will be due prior to each session.

Payment Types

An invoice with be sent via Square, where all credit cards are accepted. Information will be provided for those desiring to do direct deposits.

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