Pre-Mediation Questionnaire (Divorce)

Clinical Document Drafting and Review Services

Please provide the information requested below to issue payment for services to LUBOFSKY PC.

Step 1 of 3

Negotiated flat rate of $1,000.00 for drafting of an Informed Consent document governing independent medication management services to be provided through Heart N' Mind Counseling. Services include drafting of the agreement and up to two (2) rounds of revisions.