Client Consent to Treatment: I have carefully read and understand this statement. I have been given a copy of Elizabeth Hadley’s Professional Disclosure Statement and had it explained to me by Elizabeth Hadley. I understand the limits to confidentiality required by law. I understand my rights and responsibilities as a client, and my therapist's responsibilities to me. I agree to undertake therapy with Elizabeth Hadley. I may end therapy at any time and refuse any requests or suggestions made by Elizabeth Hadley. I have been provided with a copy of this form. I have had the opportunity to ask questions and have received needed clarification.DateDateDateI/we agree to pay the following rate per session:$110/Session$140/Couple-Family SessionSliding Scale Rate ofSliding Scale RateSend Message