Agreement for Wellness Services

Kim Townsend, D.PSc, Jordan Townsend D.PSc, and Beth Messina D.PSc are pastoral health and wellness providers, licensed in such capacity by the Pastoral Medical Association (PMA) and are required to provide certain disclosures to you and before providing services, to have on-file an agreement for services that provides clear and specific terms and conditions of the relationship. The Agreement below meets these requirements.

In this Agreement, Kim Townsend, D.PSc, Jordan Townsend D.PSc, and Beth Messina D.PSc are referred to as “Practitioner”, you are referred to as “Client”, the term “Party” refers to an indicated party to the Agreement, and the term “Parties” refers to Practitioner and you jointly.

Please read this Agreement carefully and indicate your acceptance of its terms by completing the form on the right. You will be emailed a copy of this signed agreement.

Choose Your Practitioner


CHOOSE YOUR PRACTITIONER AND FILL OUT THEIR FORM

Kim Townsend

Jordan Townsend

Beth Messina