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MOU - Therapy Intern

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    Please select your Georgia license
    • LPC - Licensed Professional Counselor
    • LCSW - Licensed Clinical Social Worker
    • LMFT - Licensed Marriage and Family Therapist
    • Clinical Psychologist - Licensed Clinical Psychologist
    • School Psychologist - Licensed School Psychologist
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    Memorandum of Understanding

    Between the Parties:

     

    Orchard Human Services, Inc.

    231 Bentonville Lane

    Douglasville, GA 30134

    and

    Signer of this Form

     

    The parties named above are executing this Memorandum of Understanding [MOU] to represent a business relationship in which Post Masters Intern shall provide mental health services to clients and other organizations on behalf of the organization Orchard Human Services, Inc.

     

    Both parties agree to operate within the boundaries of the law according to Georgia and any other state in which the therapist lawfully sees clients. Post Masters Interns shall maintain malpractice insurance and provide a copy to Orchard Human Services Inc. Intern shall maintain strict confidentiality regarding all client and patient records, abiding by all laws and restrictions according to HIPAA and to the laws of the state of Georgia regarding the practice of mental health counseling and therapy.

     

    The clients shall be retained within Orchard Human Services, Inc. as shall ownership of all printed, written, and digital materials that have been produced under the cloak of Orchard Human Services, Inc. and Psychoneuroeducational Institute, LLC.

     

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    For example: Dr. Mary Smith, PhD, LPC, NCC
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