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16 <br />FEE AGREEMENT <br />PREPLACEMENT AGREEMENT <br />I /We have read the attached policies <br />and agree to pay the established fee for a Preplacement Assessment. <br />I /We understand that the standard $1,200 as applicable. I /We understand the Preplacement <br />Assessment Fee shall be paid to the Cabarrus County Department of Social Services prior to <br />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 the Preplacement <br />Assessment. <br />This the <br />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 69 <br />