First, we want to thank you for your continued support and trust in Agape Psychological Consortium. We treat it as a privilege and look forward to an ongoing mutually beneficial relationship. Periodically, we need to remind our clients (and ourselves) of certain policies and practices within the Agency to ensure good communication. Following are the reminders. Your signature, at the end of the statement, indicates that you agree and plan to adhere to the below-stated policies.

Guardianship: Agape Psychological Consortium strives to maintain the utmost ethical and legal principles to ensure that we are providing appropriate services to all clients. Therefore, please adhere to the following:

• For parents of a minor child, please plan to sign all documents on behalf of your child. 
• For guardians (i.e., non-custodial parent) of a minor child OR guardians of an adult with a disability, please bring proof of guardianship to the first session.

Respect and courtesy: Agape Psychological Consortium is a professional environment. Therefore, please make every effort to:

• Control your child while in the waiting room so that he/she does not interfere with other clients waiting for their appointments. If necessary, we can provide a separate place for you and your child until your appointment time.
• Absolutely no eating or drinking in the waiting room. It is not a cafeteria.
• No loud or agitated conversations on the cell phone while waiting for your appointment. It makes other people uncomfortable. If necessary, please take the call outside.
• Absolutely no profanity or verbally disrespectful language.
• Absolutely no physical violence (actual or threat) is allowed and may result in you being discharged from our agency or the intervention of law enforcement (i.e., police).
•  No horseplaying. If you break anything, you pay for it.

Supervision: If your child is a minor, you absolutely cannot leave him/her unsupervised before and during his/her appointment. It is, or may be interpreted as, neglect and may warrant a call to the Dept. of Social Services for possible intervention.

Financial Responsibility: As with most programs, there is a fee for services that must be paid upon completion of the session. As such:

• Your insurance copayment is due at the time of service. If you cannot pay this amount, we will reschedule your appointment to another date that will be financially suitable for you.
• There will be a $30.00 charge for office appointments not canceled 24 hrs. in advance. If you incur this charge, it must be paid in full before any additional appointments will be scheduled.
• Your balance is always your responsibility. We file your insurance as a courtesy. If we have not been paid by your insurance carrier within 30 days of the claim being filed, we will bill you for the total amount.
• Finally, if you cannot pay the total amount of your bill, we will make payment arrangements with you. Any balance left owing after 90 days with no payment arrangement will be sent to a collection agency and/or small claims court.