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USA Youth Rehabilitation Program Admission Agreement

Prepare a Youth Rehabilitation Program Admission Agreement for a residential treatment center in the USA with this comprehensive template.
  • The agreement is between the treatment facility, the youth and a parent or guardian. The parent agrees to provide truthful information, and to support the youth's activities and participation in the program.
  • Program fees can be paid in one payment at the time of enrollment, or by regular installments. Program fees cover bedding, personal hygiene supplies, prepaid medical, etc. Any unused prepaid expenses will be refunded at the end.
  • The parent releases the facility from any liability for injury, illness, death, loss or damage suffered by the youth during participation in the program.
  • The parent authorizes the facility to obtain medical care if required, and to perform drug testing and other screening (such as HIV, pregnancy, etc).
  • The Agreement also includes an Emergency Medical Release, Personal and Family Profiles, After Care Agreement, Insurance Authorization, and checklists for use by facility personnel.
This USA Youth Rehabilitation Program Admission Agreement is available as a MS Word document and is fully editable to meet your needs.

Download: USA Youth Rehabilitation Program Admission Agreement

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