Patient Agreement Form - PursueCare

PursueCare Patient Agreement Form

Please read below then sign at the bottom.

  • Committing to participate in treatment is a big decision. Congratulations on taking this important step in your recovery. We appreciate you entrusting PursueCare with your treatment, and we look forward to supporting you along the way.

    Your success in treatment hinges on trust and mutual communication. Please read the following and check each box demonstrating that you have read and understood your obligations to yourself and to PursueCare. These obligations are required to be met throughout the course of your treatment. After you have checked each box, please sign at the bottom stating that you understand and agree to comply with the following treatment expectations. If you have any questions or concerns, please contact your intake specialist before submitting this document.

    • Date Format: MM slash DD slash YYYY