Spencer Psychology

Notification of Other Parent

If you are separated, divorced from, or never married to the child’s other parent, it is our policy to notify the other parent that we are treating your child, unless there are extenuating circumstances. If you provide false or inaccurate information to Spencer Psychology that prevents notification, please note that this could be a potential issue for you if your child’s other parent pursues a complaint.

Disagreement between Parents for Services

One risk of child therapy involves disagreement among parents and/or disagreement between parents and the therapist regarding the child’s treatment. We can hopefully resolve such disagreements, or we can agree to disagree, so long as this enables your child’s therapeutic progress. Ultimately, parents decide whether therapy will continue.


Child Name:  

Electronic Signature of Client/Parent/Guardian: