Disclaimer
The information provided herein is intended solely as a general example related to agreements between mental health professionals and clients within the United States. It does not constitute legal advice and should not be relied upon as a substitute for consulting a qualified attorney specializing in healthcare, licensing, or contractual law. Regulations and legal requirements may vary depending on the jurisdiction, and adjustments may be necessary to ensure compliance with applicable local laws. The use of this example is at the user’s own risk, and no liability is assumed for any errors, omissions, or consequences arising from its use without expert legal review.
Please note: This is a sample Therapist Contract template for reference purposes. Actual terms may differ based on specific arrangements and applicable laws.
Therapist Contract US Sample
Parties Involved:
Therapist: Jane Doe, Licensed Psychotherapist
Address: 123 Wellness Blvd, New York, NY 10001
Client: John Smith
Address: 456 Main Street, New York, NY 10002
Service Description:
The therapist agrees to provide professional mental health counseling services to the client, as described in the scope of work outlined herein.
Payment Terms:
The client shall pay the therapist a fee of $150 per session, payable at the time of each appointment, or as otherwise agreed.
Therapist Responsibilities:
The therapist commits to providing services in accordance with professional standards, maintaining confidentiality, and respecting the client’s rights.
Governing Law:
This agreement shall be governed by the laws of the State of New York. Disputes shall be resolved within the courts of New York County.
Additional Provisions:
- The client agrees to provide accurate information and attend scheduled sessions punctually.
- This agreement may only be amended in writing signed by both parties.
- Cancellation policy: 24-hour notice is required for rescheduling or cancellation without charge.
New York, ______________________
Jane Doe (Therapist)
John Smith (Client)