The Legalmiga Library/Financial Agreement & Consent for Therapy Services

  • $67

Financial Agreement & Consent for Therapy Services

An attorney-drafted Financial Agreement & Consent with easy fill-in-the blanks so that you can get it in writing - today.

🚨 A verbal “Don’t worry, I’ve got it” won’t cover your missed session fee. 🚨

What happens when a client no-shows… and then ghosts you on payment?

This Financial Agreement & Consent Template protects your practice with clear, professional terms around payment, cancellations, insurance, and billing—so you don’t have to chase down money or play phone tag with an insurance rep.

Keep it clear. Keep it documented. Get paid on time. Every time.

Fully customizable to suit your business' needs.

Your Financial Agreement & Consent Template comes with instructions on how to customize your agreement  for your specific situation.

What's Included:

  • Instant digital download of the Agreement.

  • Customizable sections outlining session fees, accepted payment methods, cancellation policies, and insurance responsibilities

  • Clear terms regarding client financial responsibility, delinquent accounts, and late cancellation fees

  • Language to protect your clinical and billing information in compliance with HIPAA and state laws

  • Optional clauses for assessments, payment plans, and card-on-file authorization

  • Plus: built-in legal protections to limit liability and establish clear expectations from day one

Instant digital download of your Financial Agreement & Consent:

[Start Here!] Instructions For Use.pdf
  • 164 KB
Financial Agreement & Consent for Therapy Services (1).docx
  • 24.8 KB

FAQs

What Is This?

A customizable financial consent form that outlines your therapy practice’s billing, payment, and cancellation policies.

Why Do I Need This?

It sets clear expectations with clients, protects your income, and helps ensure you get paid—on time and in full.

Can I Reuse This Template?

As the purchaser, you will have a limited license to use this template for personal use/for the use on behalf of one (1) business entity. You may not share this template with any other other person, client, or business entity. More information here

Is The Legalmiga Library ™ My Lawyer When I Purchase This?

No, The Legalmiga Library™ is not a law firm or your lawyer. The templates available in this Library are lawyer-drafted and lawyer-reviewed. It is important to note that law firms and attorneys provide custom,  legal advice with respect to your business' or brand's specific contract needs. See our Terms of Use for more information!