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<title>Exemplary Forms</title>
<copyright>Copyright (c) 2013 University of Massachusetts - Amherst All rights reserved.</copyright>
<link>http://scholarworks.umass.edu/psc_forms</link>
<description>Recent documents in Exemplary Forms</description>
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<lastBuildDate>Fri, 25 Jan 2013 23:14:43 PST</lastBuildDate>
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<item>
<title>Psychological Services Center Notice of Privacy Practices</title>
<link>http://scholarworks.umass.edu/psc_forms/3</link>
<guid isPermaLink="true">http://scholarworks.umass.edu/psc_forms/3</guid>
<pubDate>Mon, 29 Jun 2009 13:26:32 PDT</pubDate>
<description>
	<![CDATA[
	<p>This notice describes how psychological and medical information about you may be used and disclosed and how you can get access to this information.  Please review it carefully, and sign the acknowledgement of receipt.</p>

	]]>
</description>

<author>Psychological Services Center</author>

<source></source>

</item>


<item>
<title>Assessment Consent Form</title>
<link>http://scholarworks.umass.edu/psc_forms/2</link>
<guid isPermaLink="true">http://scholarworks.umass.edu/psc_forms/2</guid>
<pubDate>Mon, 29 Jun 2009 13:21:31 PDT</pubDate>
<description>
	<![CDATA[
	<p>Details the scope of the Psychological Services Center, the psychological assessments available and expected outcomes, describes fee structure, and the monitoring and privacy procedures during assessment testing.  This form requires the patient to sign to grant consent to the practices detailed.</p>

	]]>
</description>

<author>Psychological Services Center</author>

<source></source>

</item>


<item>
<title>Adult Consent Form</title>
<link>http://scholarworks.umass.edu/psc_forms/1</link>
<guid isPermaLink="true">http://scholarworks.umass.edu/psc_forms/1</guid>
<pubDate>Mon, 29 Jun 2009 13:19:13 PDT</pubDate>
<description>
	<![CDATA[
	<p>Details the scope of the Psychological Services Center, the treatment available and expected outcomes, details of maintaining appointments and payment, and the monitoring and privacy procedures during treatment.  This form requires the patient to sign to grant consent to the practices detailed.</p>

	]]>
</description>

<author>Psychological Services Center</author>

<source></source>

</item>



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