From the author: I looked for a similar agreement for a long time, until I gathered the strength and drew it up with the help of lawyers, now I hasten to share it with everyone in need :) Good luck...AGREEMENT No. _____on the provision of psychologist services to a minor patient. Moscow "___"___________ 20___________________________________________________________________________________________, psychologist-consultant, who is an individual entrepreneur on the basis of a state registration certificate Series____ No.___________ dated ____________________, hereinafter referred to as the "Psychologist", on the one hand, and the legal representative of the minor patient ____________________________________________, hereinafter referred to as the "Representative" , on the other hand, have entered into this agreement as follows: 1. SUBJECT OF THE AGREEMENT The psychologist undertakes to carry out psychological diagnostics and psychological correction within the boundaries of his competence, which is determined by education, forms of advanced training and relevant professional experience, of a minor patient aged ___________ years with the consent of his legal Representatives - parents, and the legal Representatives undertake to pay the Psychologist the cost of the services provided. 1.2. Information about the minor patient: Full name _______________________________________________________ Age: _____________________date of birth ___________________1.3. The signing of this Agreement constitutes the consent of the legal representatives of the minor in accordance with Art. 26.28 Civil Code of the Russian Federation.2. CONTRACT PRICE2.1. The cost of services is determined in accordance with the Appendices to this agreement, which are an integral part of this agreement.3. TERMS OF PAYMENT3.1. At the request of the Representative of a minor patient acting in the interests of the patient, the cost of services provided by the Psychologist can be paid either by the Representative himself, or by the patient's insurance company, or by a third interested individual or legal entity on the basis of a document issued by the Psychologist.3.2. At the request of the Representative of a minor patient and in agreement with the Psychologist, it is possible to pay for each psychological service separately immediately after its provision or after the provision of a set of psychological services in accordance with the Appendices to the Agreement. 3.3. The fulfillment of the obligation by the Representative to pay for psychological services is considered fulfilled only after the money has been received at the cash desk or to the Psychologist’s bank account with the provision of a copy of the payment receipt.4. RIGHTS AND OBLIGATIONS OF THE PARTIES4.1. The psychologist undertakes to: Conduct a psychological diagnosis of a minor patient and, based on its results, psychological correction. Conduct dynamic observation of a minor patient during the correction period. Not disclose information about the patient or the results of counseling and not provide third parties with access to this information, incl. and his representatives without his consent. The psychologist stops his intervention when it becomes clear that the patient no longer needs his services and/or further work does not bring results, and its continuation may harm the patient.4.2. The Psychologist has the right to: Refuse to carry out psychological correction if the Representatives of the minor patient fail to comply with the Psychologist’s requirements. If a minor patient is found to have contraindications for psychological correction, refuse the Representative of the minor patient to provide psychological services. Suspend the provision of psychological services in the event of illness, loss of ability to work, relocation, etc. than notifying the Representative in advance.4.3. The patient's representative undertakes to: Read and sign all necessary documents on voluntary consent to psychological services for a minor patient. Complete allrecommendations of the Psychologist. Timely bring the minor patient to an appointment with the Psychologist at the appointed time, if it is impossible to notify the Psychologist in advance. 4.4. The patient's representative has the right to: Receive significant information regarding all psychological services provided by a psychologist, taking into account the principles of confidentiality of psychological diagnosis and correction of a minor patient. Disclosure of information. A psychologist discloses confidential information without the patient's consent only in cases provided for by law, as well as if this is aimed at: 1. providing the necessary professional assistance to the patient;2. carrying out the necessary professional consultations;3. patient protection.5. RESPONSIBILITY OF THE PARTIES5.1. If the representative fails to comply with recommendations and requirements, the Psychologist has the right to terminate the contract unilaterally.5.2. All disagreements under this Agreement will be resolved by the parties through negotiations. If disagreements are not resolved, the parties may go to court to protect their rights.6. OTHER CONDITIONS6.1. This agreement comes into force from the moment it is signed and is valid until the parties fully and properly fulfill all its terms.6.2. This agreement has been drawn up in two copies, one for each party. Both copies have the same legal force.6.3. All issues not regulated by this agreement are resolved in accordance with the current legislation of the Russian Federation.7. DURATION OF THIS AGREEMENT 7.1. The obligations under this agreement come into force from the moment it is signed and are valid until the end of the entire course of psychological correction, which, according to preliminary data, may amount to ______________ meeting, one meeting lasting ____________ minutes, with a frequency of ______________ per week/month.7.2. After the end of the period of psychological correction described in clause 7.1. the parties discuss the results of psychological influence and make a decision either to terminate or to continue psychological correction.7.3. If a decision is made to continue psychological correction, the parties enter into a new Agreement, or all conditions for extending psychological correction are described in a new Appendix to this Agreement.8. ADDRESSES AND SIGNATURES OF THE PARTIESPsychologist: ____________________________________Certificate of state registration Series ___ No. ___________ of the year behind the state registration number of an individual entrepreneur ______________________________Patient's representative:________________________________________________________________________________Passport details: ________________________________________________________________________________Signature ______________________M.P.Signature_____________(________________)Appendix No. 1 to AGREEMENT No.____ dated "___" __________ 20__ provision of psychological services to a minor patient. Moscow "___"___________ 20___________________________________________________________________________________________, psychologist-consultant, who is an individual entrepreneur on the basis of a state registration certificate Series____ No.___________ dated ____________________, hereinafter referred to as the "Psychologist", on the one hand, and the legal representative of the minor patient ____________________________________________, hereinafter referred to as the "Representative" , on the other hand, have concluded an Appendix to this agreement as follows: The price under this agreement for the provision of psychological services, including psychological diagnostics and psychological correction at the rate of 1 meeting lasting _________ minutes is ________ (__________________________________________________________) rubles. Payment is made before the provision of psychological services provided for in this Annex. The validity period of this Annex comes into force from the moment it is signed and is valid until the full completion of execution_____________(________________)