Psychotherapy Practice Development Salon
MEMBER AGREEMENT
This is a participation agreement between the Salon Member (Signatory below) and Dr. John Nickens.
It is the intention of the Salon Leadership to provide a unique opportunity to learn about the development and operation of a Psychotherapy Private Practice, including aspects of Management, Marketing and Therapeutics that contribute to the development of an effective and robust Private Practice. Membership is limited to fifteen individuals in any particular section of the Salon. Each section will meet as a group once-per-week. Each meetings lasts three hours.
The expectations of Salon members are as follows:
1. Maintenance of a collegial, open and respectful perspective, realizing that each Salon member has a unique
experience and practice style.
2. Active participation in the group discussions, including offering and accepting suggestions and critique,
the completion of homework if assigned, and the sharing of professional contacts and resources as appropriate
for the benefit of the entire group.
3. Attendance at all scheduled meetings unless otherwise arranged.
4. Maintain financial responsibility during the Salon term. Total cost for the Salon is $300.00 for the 6-hr section
or $525.00 for 12-hr section.
Payment may be made by credit card or check.
Payment must be made in advance for all sessions regardless of attendance (necessary to maintain a small group size).
5. Contribution to a light pot-luck meal for each meeting.
Please be aware that Dr. John Nickens cannot guarantee, as a result of your participation in the Salon, that you will meet your goals or that your practice will increase in either client numbers or financial returns. Results will vary.
Please indicate your payment method: ___ Credit Card (You may pay via Visa, M/C, AmEx or Discover card.)
___ Check
Please make checks payable to: John Nickens, PhD, c/o Salon, 465-34th St. Oakland, CA 94609
Credit cards will be processed on-site at the first session.
Please indicate your agreement with your signature and date and return to address above:
____________________________________________________ ________________
Salon Member Date Date
Click on the icon below to download a copy of this form.
MEMBER AGREEMENT
This is a participation agreement between the Salon Member (Signatory below) and Dr. John Nickens.
It is the intention of the Salon Leadership to provide a unique opportunity to learn about the development and operation of a Psychotherapy Private Practice, including aspects of Management, Marketing and Therapeutics that contribute to the development of an effective and robust Private Practice. Membership is limited to fifteen individuals in any particular section of the Salon. Each section will meet as a group once-per-week. Each meetings lasts three hours.
The expectations of Salon members are as follows:
1. Maintenance of a collegial, open and respectful perspective, realizing that each Salon member has a unique
experience and practice style.
2. Active participation in the group discussions, including offering and accepting suggestions and critique,
the completion of homework if assigned, and the sharing of professional contacts and resources as appropriate
for the benefit of the entire group.
3. Attendance at all scheduled meetings unless otherwise arranged.
4. Maintain financial responsibility during the Salon term. Total cost for the Salon is $300.00 for the 6-hr section
or $525.00 for 12-hr section.
Payment may be made by credit card or check.
Payment must be made in advance for all sessions regardless of attendance (necessary to maintain a small group size).
5. Contribution to a light pot-luck meal for each meeting.
Please be aware that Dr. John Nickens cannot guarantee, as a result of your participation in the Salon, that you will meet your goals or that your practice will increase in either client numbers or financial returns. Results will vary.
Please indicate your payment method: ___ Credit Card (You may pay via Visa, M/C, AmEx or Discover card.)
___ Check
Please make checks payable to: John Nickens, PhD, c/o Salon, 465-34th St. Oakland, CA 94609
Credit cards will be processed on-site at the first session.
Please indicate your agreement with your signature and date and return to address above:
____________________________________________________ ________________
Salon Member Date Date
Click on the icon below to download a copy of this form.

salon_participant_agreement_b-2013.docx | |
File Size: | 15 kb |
File Type: | docx |