Baby spirit

CAT-Baby Spirit treatment agreement

For massages and family-child therapy

Name of CAT therapist:

Client Name

By signing this document, the therapist and client acknowledge that: - The client is entering into treatment with the therapist and has been informed of the rates charged by this therapist. - The client is aware of and consents to the treatment option(s) chosen jointly and proposed by the therapist, and is aware of and consents to the treatment plan drawn up by the therapist (taking into account that a treatment plan is an estimate). - That the client has the right to privacy and confidentiality regarding medical data. - The therapist is obliged to refer the client to a colleague therapist or doctor if the treatment is insufficient or cannot be continued due to illness, death, or a medical condition. - Termination of treatment may take place at any time by mutual consent. - Termination of treatment may take place unilaterally by the client if the client no longer values or deems the treatment necessary. - If the treatment is terminated by the client against the advice of the therapist; the client does this at their own risk and is willing to sign a statement in which the client acknowledges terminating the treatment without the therapist's approval. - The treatment may be terminated unilaterally by the therapist if it cannot reasonably be expected of him/her to continue the treatment. - The client is aware of the complaints procedure and may address complaints to the government-recognized WKKgz disputes body managed by the therapist. www.gatgeschillen.nl - Payment takes place by mutual agreement between the client and the therapist; in cash, by debit card per consultation, etc. The client receives an invoice (handed over directly or by post or email, for example) from the therapist as soon as the therapist has confirmation that the payment has been completed. - The client is aware that the therapist maintains an electronic client file and has the right to access it, have errors corrected, add personal statements, and have data destroyed (the treatment agreement and treatment plan containing the client's personal data must remain present therein). - The therapist handles this client file in accordance with the GDPR and the privacy statement as found on www.babyspirit.nl. - The therapist is obliged to retain the client file for 20 years and, in the case of a minor client, to retain it for 20 years after the client reaches the age of 18. - If the minor dies before reaching the age of 18, the client file will be retained for at least 18 years after the year of birth. - The client is aware of the colleague therapist with whom the therapist has concluded a substitution and transfer agreement. The colleague therapist may cover the practice in the event of the therapist's absence or take over in the event of the practice closing. Additional questions, please fill in what applies;

Does the client object to the sharing of the client file when the practice is being covered by a colleague therapist?

Does the client object to the transfer of the client file when the practice is taken over by a colleague therapist?

Datum

Confirmation of agreement, CAT Therapist Ms. Kas-Duikersloot

Client Confirm Approval