MH Services & Financial Agreement - Staff Requested
Person signing forms is the:
A. PERMISSION FOR TREATMENT
I agree to permit employees and interns of Minnesota CarePartner to provide services to me. I understand that Minnesota CarePartner can make no guarantees about the outcome of my treatment, but that I can expect to receive services that are ethical and professional. I understand that Minnesota CarePartner agrees to comply with all privacy laws and respects my right to confidentiality. As a client, I agree to attempt to be honest and to disclose information to assist the MNCP staff in providing appropriate services.
Under the above conditions, I provide my consent to receive services from Minnesota CarePartner
B. FINANCIAL AGREEMENT
Leave this empty:
Your legal name
Your email address
If you have questions about the contents of this document, you can email the document owner.
Document Name: MH Services & Financial Agreement - Staff Requested
Agree & Sign