Treatment Agreement Template Classroom

You can open the Treatment Agreement Template Classroom in multiple formats, including PDF, Word, and Google Docs.


Sample

Treatment Agreement Template Classroom

Printable | Editable Form




Treatment Agreement Template Classroom (1)
Between:
[Name of the Therapist]
[Therapist’s ID]
[Therapist’s Address]
[Therapist’s Phone]
[Therapist’s Email]
And:
[Name of the Client/Student]
[Client’s ID]
[Client’s Address]
Introduction:
This document formalizes the treatment agreement for services to be provided in a classroom setting, commencing on [Contract Start Date].
Clause 1: Description of Services
The Therapist agrees to provide the following services: [Specify services such as individual therapy sessions, group therapy sessions, educational workshops].
Clause 2: Duration and Schedule
Services will be provided over a period of [Specify duration], following the schedule of [Specify schedule].
Clause 3: Fees and Payment Terms
The Client agrees to compensate the Therapist a fee of [Amount] to be paid according to the following terms: [Specify terms, e.g., monthly, per session].
Clause 4: Cancellation Policy
Either party may cancel any scheduled session with [Notice Period] notice, and cancellation fees may apply under the following circumstances: [Specify circumstances].
Clause 5: Confidentiality
Both parties agree to uphold the confidentiality of all shared information during the course of treatment, maintaining the privacy of all records and communications.
Clause 6: Liability
The Therapist will not be held liable for any injuries or damages resulting from services rendered in this agreement, except in cases of gross negligence.
Clause 7: Governing Law
This agreement will be governed by the laws of [Jurisdiction].
Signed in [City], [Date].
Sincerely,
[Signature of the Therapist]
[Name of the Therapist]
[Signature of the Client/Student]
[Name of the Client/Student]
Treatment Agreement Template Classroom (2)
Between:
[Name of the Therapist]
[Therapist’s ID]
[Therapist’s Address]
[Therapist’s Phone]
[Therapist’s Email]
And:
[Name of the Client/Student]
[Client’s ID]
[Client’s Address]
Introduction:
This agreement outlines the treatment services to be provided in a classroom setting, effective from [Contract Start Date].
Clause 1: Services Provided
The Therapist will provide: [List of specific services such as assessments, behavioral interventions, etc.].
Clause 2: Session Structure
Sessions will last for [Specify duration, e.g., 50 minutes], and will occur [Specify frequency, e.g., weekly, bi-weekly].
Clause 3: Fees and Payment Schedule
The Client agrees to pay [Amount] as per the following schedule: [Specify detailed payment terms].
Clause 4: Termination Conditions
The agreement may be terminated under conditions including failure to attend scheduled sessions or non-payment after [Number of Notices].
Clause 5: Consent
The Client/Student, or their guardian, must provide informed consent before participation in any treatment program and retain the right to withdraw at any time.
Clause 6: Conflict Resolution
In the event of disputes arising from this agreement, both parties agree to seek resolution through mediation before pursuing legal avenues.
Clause 7: Governing Law
This agreement is subject to the laws of [Jurisdiction].
Signed in [City], [Date].
Sincerely,
[Signature of the Therapist]
[Name of the Therapist]
[Signature of the Client/Student]
[Name of the Client/Student]

Form

Please complete the form below to create the Treatment Agreement Template Classroom. All fields must be filled out to ensure a clear and complete agreement. We provide examples to guide you through each step.

Treatment Agreement Template Classroom

1. Student Information


2. Guardian Information


3. Treatment Provider Information


4. Treatment Details

5. Schedule of Sessions


6. Confidentiality Terms

7. Fees and Payment Structure

8. Termination Policy

9. Rights and Responsibilities

10. Signatures and Agreement

11. Declaration and Signatures





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WORD

Printable

Treatment Agreement Template Classroom

Printable | Editable Form




Treatment Agreement Template Classroom