General Acknowledgement of Forms

I hereby acknowledge and agree that I had read all of the forms and documents provided to me in connection with evaluation and treatment provided by Branched Out Therapy, Inc. and/or their employees.
I understand the meaning and intent of the provided forms and agree to all content included.
I have been given an opportunity to ask questions about the provided forms and Branched Out Therapy, Inc. has answered all questions I’ve asked to my satisfaction.

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Signature of Participant or Legal Representative *

Relationship to Client *