Comprehensive Diagnostic Evaluation

This agreement is to serve as a contract for services between the Family Guidance and Therapy Center and 

on behalf of

Scope of Evaluation:

Dr. Hobson conducts evaluations and has agreed to conduct a

in accordance with the Individuals with Disabilities Education Act (IDEA) and state law requirements, prepare a written report of her findings, provide

with a copy of her report upon its completion, and (upon request) present the report to the student’s IEP team.

The Scope of her evaluation will be determined by the combination of three information sources:

• Questions/concerns that the responsible party would like for Dr. Hobson to try to address by the evaluation;
• Questions/concerns that other involved parties (e.g. parents and those working with the client) would like for her to try to address;
• Questions/ concerns that Dr. Hobson has after reviewing the records.

General Fee Information:

Dr. Hobson agrees to undertake the evaluation, not including all related expenses (e.g. travel, observations, assessments, preparing a report, providing a copy of the report to responsible party, and presenting a copy of the report to the IEP team) at the rate of

/hour plus expenses, not to exceed 

Family Guidance and Therapy Center will invoice

for a deposit of

and for the balance due upon completion of services. Payment is due on receipt of invoice. Dr. Hobson may withhold the final report until the balance is paid in full.

Additional Notations:

To execute this Contract, a signature at the end is required.

By signing below, you acknowledge a copy of your receipt of, your understanding about, and your agreement to abide by the requirements set forth in this Contract for Services. Furthermore, you consent that any dispute arising out of or relating to the Services I provide and/or to the Terms of this Contract, whether based in contract, tort, statutory or other law, will be governed by the laws of the State of California, excluding its conflicts of law provisions. You further consent to the personal jurisdiction of and exclusive venue in the federal and state courts located in and serving San Diego County, California as the legal forum for any such dispute.