Treatment Plan Acknowledgement eSignature
Client Name: Date of Birth: Primary Counselor:
By signing this form, I acknowledge that I have participated in the development and revision of my individualized treatment plan and agree with the contents of the plan.
I also acknowledge that any items marked “Must be reached to have services terminated” must be completed before I am able to complete the primary phase of the treatment program with a “successful completion” designation.
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If you have questions about the contents of this document, you can email the document owner.
Document Name: Treatment Plan Acknowledgement eSignature
Agree & Sign