Client Services Agreement. This Agreement is entered into and is governed by the Client Services Agreement, the terms and conditions of which are incorporated herein by reference and remain in effect. To the extent a term or condition in the Client Services Agreement is contrary to a term or condition in this Agreement and the term or condition in this Agreement is required to ensure compliance with HIPAA, the term or condition in this Agreement shall control.
Client Services Agreement. Welcome to my practice. This document (the Agreement) contains important information about my professional services and business policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a new federal law that provides new privacy protection and new patient rights with regard to the use and disclosure of your Protected Health Information (PHI) used for the purpose of treatment, payment and health care operations. HIPPA requires that I provide you with a Notice of Privacy Practices (the Notice) for use and disclosure of PHI for treatment, payment and health care operations. The Notice, which is attached to this Agreement, explains HIPPAA and its application to your personal health information in greater detail. The law requires that I obtain your signature acknowledging that I have provided you with this information at the end of this session. Although these documents are long and sometimes complex, it is very important that you read them carefully before our next session. We can discuss any questions you have about the procedures at that time. When you sign this document, it will also represent an agreement between us. You may revoke this Agreement in writing at any time. That revocation will be binding on me unless I have taken action in reliance on it; if there are obligations imposed on me by your health insurer in order to process or substantiate claims made under your policy; or if you have not satisfied any financial obligations you have incurred. Psychotherapy is not easily described in general statements. It varies depending on the personalities of the counselor and client, and the particular problems you are experiencing. There are many different methods I may use to deal with the problems that you hope to address. Psychotherapy is not like a medical doctor visit. Instead, it calls for a very active effort on your part. In order for the therapy to be most successful, you will have to work on things we talk about both during our sessions and at home. Psychotherapy can have benefits and risks. Since therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness, and helplessness. On the other hand, psychotherapy has also been shown to have many benefits. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress. But there are...
Client Services Agreement. Seller and the Members shall have executed a client services agreement (“Client Services Agreement”) in a form to be mutually agreed on by the parties.
Client Services Agreement. A separate Client Services Agreement may be executed, these Terms take precedence in case of conflict.
Client Services Agreement. Please read the following pages and feel free to ask questions. As required by Washington State law, I will ask you to acknowledge that you are aware of this information. Feel free to keep this copy or read this statement on my website. Please call me to make an appointment. I can best be reached at 847-477-0355. I check my messages frequently and will return your call most likely the same day, but certainly within 24 hours. If you need to speak to someone urgently and I am not available, please call the Crisis Clinic at (000) 000-0000 or go to the nearest hospital emergency room. Therapy sessions start as scheduled and last 50 minutes. Please call at least 48 hours in advance if you need to reschedule or cancel an appointment. Otherwise, you will be billed the full fee for the session. Please note that if you are using insurance for your therapy and you miss a session, you will be responsible for the full appointment because your insurance will not pay for missed appointments.
Client Services Agreement. By signing your signature below you indicate that you have been given, received, and read the counselor-client services agreement and the notices and forms therein and agree to its terms.
Client Services Agreement. Welcome to my practice. This document contains important information about my professional services and business policies. Please read it carefully and note any questions you might have so that we can discuss them at our next meeting. When you sign this document, it will represent an agreement between us.
Client Services Agreement. Xxxxxxxxx shall have executed the Client Services Agreement.
Client Services Agreement. I acknowledge that I have received a copy of Client Services Agreement for Northwest Speech Therapy/ Spotlight Social Skills along with the Notice of Policies and Practices to Protect the Privacy of Your Health Information. My signature below acknowledges that I have read and understand the information provided, and that I agree to the foregoing terms.
Client Services Agreement. Welcome. Please read the information below and note any question so we can discuss them. Therapy is hard to describe. Each person experiences it differently. The are many different ways to work on the problems you want to solve. Therapy requires you to actively participate both in the therapy appointment and in the work you will asked to do outside our meeting. Therapy has benefits and risks. Therapy may involve discussing unpleasant experiences. You may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness, and helplessness. Therapy has also been shown to have many benefits. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress. We don’t know what your experience will be like. By the end of the first few sessions, I will be able to offer you some ideas of what our work together might include going forward. Together we can discuss what a plan to meet your needs might look like. Giving careful consideration to this conversation as well as to your own feelings of comfort with the therapy process, including the financial and time commitment, you should then make a decision about continuing with therapy.
