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I agree to permit employees of Minnesota CarePartner to provide services to me. I understand that Minnesota CarePartner can make no guarantees about the outcome of my treatment, but that I can expect to receive services that are ethical and professional.
I understand that Minnesota CarePartner agrees to comply with all privacy laws and respects my right to confidentiality. As a client, I agree to attempt to be honest and to disclose information to assist the MNCP staff in providing appropriate services.
1. I agree to attend scheduled appointments or notify service providers if I need to reschedule an appointment.
2. I agree to participate in treatment planning, that is, developing and implementing a functional assessment and individual treatment plan.
I attest that:
I acknowledge the following:
I hereby release and agree to hold Minnesota CarePartner, LLC harmless from, and waive on behalf of myself any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of the counseling practice, or that may otherwise arise in any way in connection with any services received from Minnesota CarePartner, LLC. I understand that this release discharges Minnesota CarePartner, LLC from any liability or claim that I, my heirs, or any personal representatives may have against the practice with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from Minnesota CarePartner, LLC. This liability waiver and release extends to the counseling practice together with all therapists and other employees.
Minnesota CarePartner/Roots Recovery is now Roots Wellness Center