MATTHEW J. SULLIVAN, Ph.D.
Clinical Psychology                                          ____________________ 
417 Tasso St. Palo Alto, CA  94301	                                                         
Lic # PSY10214                             	                                                           Phone # (650) 326-2004

Consultant Agreement and Fee Policies

The purpose of this Agreement is to explain the service and fee arrangements for Matthew J. Sullivan, Ph.D., who has been retained to provide confidential consultation to _____________________, who is represented by __________________ in a family law matter. I understand that Dr. Sullivan may not agree with my perspectives, but will provide services and opinions within the scope of his expertise. I understand that Dr. Sullivan will not become a disclosed expert to testify on my behalf in this case unless it is by mutual agreement.

Consultation is confidential and may be protected by the attorney-client work product privilege and unless I provide written authorization for Dr. Sullivan to  release case information. The following circumstances, however, are exceptions to the confidentiality of my work in this matter. I have been informed that under California statutes that designate my duties as a mental health professional,  a) if an individual communicates to me a serious threat to harm an identifiable person, I must warn that person and the police; (b) if I suspects child abuse or neglect, or abuse of a dependent adult or of a person over the age of 65, a report must be made to the appropriate agency; and (c) if you seem dangerous to self or other, or is unable to care for him or herself, hospitalization may be required.

Further, I understand that information and records otherwise confidential and/or testimony concerning the case or me must be provided in the event of a court order demanding it. 

Dr. Sullivan’s consultation fees are $450.00 per hour which includes all time which he spends on my case. His services may include office consultations, telephone/email consultations, drafting of written reports and letters, attendance at depositions and other court proceedings and travel time necessary to fulfill his role.  All billing will go through the attorney’s office to protect the confidentiality of the consultant’s work.

I understand I will receive a monthly itemized statement for consultation services. Full payment of fees owed are due upon receipt of this statement. Any outstanding balance is considered late after 25 days of receipt of the statement, and accrue a late fee of 1.5% per month.

Signature of Client:_________________________/Date:___________