Service Agreement
Effective Date: September 2025
This Service Agreement (“Agreement”) is entered into between the participant (“Client”) and Realign Psychotherapy (“Provider”).
1. Services Provided
The Provider agrees to offer the following services to the Client, as scheduled and agreed upon:
Psychotherapy Services: mental health support, counseling, and therapeutic interventions within the Provider’s professional scope of practice.
Yoga Services: instruction, guidance, and facilitation of yoga practices, classes, or workshops.
2. Client Responsibilities
The Client agrees to:
Provide accurate and complete information relevant to their physical and mental health.
Assume responsibility for their own participation and decisions.
Attend scheduled appointments on time or provide notice of cancellation (see Section 5).
Refrain from engaging in services under the influence of drugs or alcohol (unless prescribed and disclosed).
3. Confidentiality
Psychotherapy sessions are confidential, except as required by law (e.g., risk of harm to self or others, suspected abuse, or court order).
Yoga sessions are not confidential but will be conducted with respect for privacy.
The Provider will maintain records securely in compliance with applicable privacy regulations.
4. Fees & Payment
The Client agrees to pay the Provider at the agreed-upon rate of per session or class.
Payments are due ahead of the session start time [Payment due date will be specified]
Accepted payment methods: bank transfer
.
5. Cancellation & Rescheduling
Cancellations must be made at least 24 hours before the scheduled session.
Late cancellations or missed appointments may result in a full session fee being charged.
The Provider reserves the right to reschedule sessions if necessary.
6. Risks & Disclaimers
The Client understands that psychotherapy may involve emotional discomfort and yoga may involve physical exertion, with associated risks.
Services are not a substitute for medical, psychiatric, or emergency care.
The Provider makes no guarantees regarding outcomes.
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