I agree to allow the psychologist at Agape Psychological Consortium to perform a psychological evaluation and/or clinical assessment on myself and/or my child. I understand that these services may include:

• Face-to-face contact with the client and/or other adults who may have additional information (e.g., group home director/designate, guardian, case manager)
• Retrieval and review of previous evaluations and/or documents that could provide contextual information for the presenting issues/concerns
• Time required for the reading of records, consultations with other professionals
• Scoring and interpretation of test results
• Report writing

If I have questions or concerns about the assessment process, the evaluator agrees to be available to discuss these before and after completion of the process. I also understand the psychologist agrees to the following: 

• The procedures for selecting, giving, and scoring the tests, interpreting the results, and maintaining my privacy will be carried out in accord with the rules and guidelines of the American Psychological Association and with applicable state and federal laws.
• Tests will be chosen that are suitable for the purposes described above. These tests will be given and scored according to the instructions in the tests’ manuals, so that valid scores will be obtained. These scores will be interpreted according to scientific findings and guidelines from the scientific and professional literature.
• Tests and test results will be kept in a secure place to maintain their confidentiality.
• Unless referred by the Court or the Department of Social Services, the evaluation results will be sent or given to the client, legal guardian, or designate. If the referral is from the Court or the Department of Social Services, then the evaluation results will be sent directly to the referring person/agency.
• Under normal circumstances, the actual report should be available within two weeks of the final session date. If there is an unforeseen circumstance that would delay the final report, we will call you to inform you of the situation and to discuss an alternate report date.

I agree to help as much as I can, by supplying full answers, making an honest effort, and working as best I can to make sure that the findings are accurate.