I
hereby consent to engage in telehealth psychological testing services for myself/my child through
I understand that I have the following rights with respect to telehealth testing services:
By signing below, I acknowledge that I have both read and understood the information in this document and in West County Psychological Associates Informed Consent for Testing Services, and agree to the terms of both documents. This consent ends when I notify my clinician that I am terminating telehealth testing services or one year following my receipt of the written report describing my testing results.
In the case of a minor client, the signature of a parent is required.
NOTE: If parents are divorced or legally separated, the signatures of both parents are required unless otherwise stated in the legal parenting plan.