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15 <br />FEE AGREEMENT <br />ANNUAL PREPLACEMENT ASSESSMENT UPDATE <br />I /We have read the attached policies and agree <br />to pay the established $400.00, for an annual Pre - Placement Assessment Update. <br />I /We understand the fee is due prior to services rendered. <br />If this fee is waived or reduced, individual arrangements will be made. <br />I /We understand that this Fee Agreement is not based on the outcome of Annual Preplacement <br />Assessment Update. <br />This the day of , <br />Signature <br />Signature <br />Address <br />City /State /Zip <br />Social Worker <br />1303 S. Cannon Blvd • Kannapolis, North Carolina 28083 • State Courier #: 05 -09 -02 •704.920.1400 • Fax <br />704.920.1401 <br />www.cabarruscounty.us/aovernment/departments/social-services <br />Striving to improve the quality of life in the community for all citizens. <br />Attachment number 1 <br />F -2 Page 68 <br />