Michael J. Brown, MSC, LMFT
Happy Couples Healthy Communities
Consent to Treatment/Agreement to Pay
I do hereby consent to treatment with Michael J. Brown, MSC, LMFT.
I have not been given any guarantees in regard to treatment.
I may terminate my treatment at any time, but I will still be responsible for payment for services received.
I agree to pay Michael J. Brown for all services rendered at the time services are provided.