Legal Doc – Gateway Academy Transition Course

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 Included but not limited to, 4 week online transition support course, 3 individual parent coaching session(s), 1 joint session with program therapist and constant collaborative contact with Gateway Academy and other identified professionals. These services also include utilizing email and texting for needed connection in between weekly support sessions that are not identified as crisis work.
$725 that includes the above services. These services must be used within 6 weeks of signing date.

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

All credit cards accepted. Information provided for those desiring to do direct deposits. Checks can be written directly to: Solutions Parenting Support
and mailed to: PO Box 773885. Steamboat Springs, CO 80477

I will pay by check
I will pay by credit card
I will pay by direct deposit

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Legal Doc – Gateway Academy Transition Course

Legal Doc - Gateway Academy Transition Course