ACCESS TO PROTECTED HEALTH INFORMATION. You have the right to inspect and obtain a copy of the protected health information contained in clinical, billing and other records used to make decisions about you. Your request must be in writing. We may charge you related fees. There are some limitations to this right, which will be provided to you at the time of your request, if relevant, along with the appeal process available to you. To exercise this right, ask your therapist for the appropriate request form.
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Samples: Client/Therapist Agreement, Client Therapist Agreement, Client Therapist Agreement