Advocacy Contract

Keischa Pruden - Advocate

1-866-200-9849/www.prudencounselingconcepts.com
Name

First Name Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Advocacy Package Requested:

Basic (IEP/504 Review and 3 Recommendations) 97.00 Basic plus Parent IEP Binder 197.00 Basic Enhanced (Assistance with completing binder) 297.00 IEP Support (Basic plus IEP Binder, Parent Input Statement Assistance, 1 IEP Meeting Prep Session, IEP Meeting Attendance - 1 meeting) 497.00 IEP Support Plus (IEP Support plus 2 calls or emails per month) 697.00 Other
Contract Provisions:

Service Provision: Advocacy services will be perforned virtually and according to services requested.

In the event in person services are deemed appropriate, client agrees to reimburse Keischa Pruden for mileage at the rate of .56 per mile.

In the event client requires additional services other than those contracted, client agrees to pay additional fees associated with services.

Emails and phone calls will be responded to within 24 hours of receipt of communication, within the hours of 10 am - 5pm. In the case of emergencies (physical/psychiatric), clients are advised to call 911.

Payment: unless previously agreed upon, payment for all services are due upon receipt of contract and before services are provided.

Contract Termination: Each party in this contract agrees to provide at least 30 days notice of contract termination. All fees eligible for reimbursement will be disbursed within 45 days of contract termination date.
I, Signature am requesting to enter into an advocacy agreement with Keischa Pruden. I understand Keischa Pruden is not an attorney and her guidance is not to be construed as legal advice. I understand Keischa Pruden is a licensed psychotherapist and her guidance is not to be construed as provision of psychotherapy.
Date

Month Day Year
Date
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Keischa Pruden - Advocate