Right to Receive Confidential Communications by Alternative Means and at Alternative Locations. You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For example, you may not want a family member to know that you are seeing us. On your request, we will send your communications to another address.)
Appears in 14 contracts
Samples: Psychologist Client Services Agreement, Therapist Client Services Agreement, Therapist Client Services Agreement
Right to Receive Confidential Communications by Alternative Means and at Alternative Locations. You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For example, you may not want a family member to know that you are seeing usme. On your request, we I will send your communications bills to another address.)
Appears in 14 contracts
Samples: Psychotherapy Services Agreement, Psychotherapy Services Agreement, Psychologist Client Services Contract
Right to Receive Confidential Communications by Alternative Means and at Alternative Locations. You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For example, you may not want a family member to know that you are seeing usme. On Upon your request, we I will send your communications bills to another address.)
Appears in 12 contracts
Samples: Agreement for Fees and Psychological Services, Psychotherapist Patient Services Agreement, Patient Services Agreement
Right to Receive Confidential Communications by Alternative Means and at Alternative Locations. You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For example, you may not want a family member to know that you are seeing us. On Upon your request, we will send your communications bills to another address.)
Appears in 10 contracts
Samples: Service Agreement, Informed Consent Notice and Fee and Payment Agreement, Service Agreement
Right to Receive Confidential Communications by Alternative Means and at Alternative Locations. You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For example, you may not want a family member to know that you are seeing usa counselor at this office. On your request, we this office will send your communications bills to another address.)
Appears in 3 contracts
Samples: Counselor – Patient Service Agreement, Counselor – Patient Service Agreement, Counselor – Patient Service Agreement
Right to Receive Confidential Communications by Alternative Means and at Alternative Locations. You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For example, you may not want a family member to know that you are seeing us. On your request, we will send your communications to another address.)
Appears in 2 contracts
Samples: Therapy Consent, Policies & Agreement, Informed Consent for Therapy Services
Right to Receive Confidential Communications by Alternative Means and at Alternative Locations. You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For exampleIf your request is reasonable, you may not want a family member to know that you are seeing us. On your request, then we will send your communications to another addresshonor it.)
Appears in 2 contracts
Samples: Fee Agreement/Consent to Treatment, Fee Agreement/Consent to Treatment
Right to Receive Confidential Communications by Alternative Means and at Alternative Locations. You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. locations (For for example, you may not want a family member to know that you are seeing usme. On Upon your request, we I will send your communications bills to another address).)
Appears in 2 contracts
Samples: Agreement and Informed Consent to Treatment, Agreement and Informed Consent to Treatment
Right to Receive Confidential Communications by Alternative Means and at Alternative Locations. You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For example, you may not want a family member to know that you are seeing usa therapist. On your request, we will send your communications bills to another address.)
Appears in 1 contract
Right to Receive Confidential Communications by Alternative Means and at Alternative Locations. You have the right to request and receive received confidential communications of PHI by alternative means and at alternative locations. (For example, you may ay not want a family member to know that you are seeing usme. On your Upon request, we I will send your communications bills to another address.)
Appears in 1 contract
Samples: Informed Consent and Psychologist/Patient Agreement
Right to Receive Confidential Communications by Alternative Means and at Alternative Locations. You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For example, you may not want a family member to know that you are seeing usme. On Upon your request, we I will send your communications bills to another address. You may also request that I contact you only at work, or that I do not leave voice mail messages.)) To request alternative communication, you must make your request in writing, specifying how or where you wish to be contacted.
Appears in 1 contract
Samples: Treatment Consent and Agreement
Right to Receive Confidential Communications by Alternative Means and at Alternative Locations. You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For example, you may not want a family member to know that you are seeing usme. On your request, we I will send your communications bills to another address.)
Appears in 1 contract
Right to Receive Confidential Communications by Alternative Means and at Alternative Locations. You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For example, you may not want a family member to know that you are seeing usme. On your request, we BCS will send your communications bills to another address.)
Appears in 1 contract
Right to Receive Confidential Communications by Alternative Means and at Alternative Locations. You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For example, you may not want a family member to know that you are seeing usme. On your request, we will send your communications bills to another address.)
Appears in 1 contract
Samples: Agreement for Psychological Services and Informed Consent
Right to Receive Confidential Communications by Alternative Means and at Alternative Locations. You have the right to request and receive confidential confidential communications of PHI by alternative means and at alternative locations. (For example, you may not want a family member to know that you are seeing us. On your request, we will send your communications to another address.)
Appears in 1 contract
Right to Receive Confidential Communications by Alternative Means and at Alternative Locations. You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For example, : you may not want a family member to know that you are seeing usme. On Upon your request, we I will send your communications xxxx to another address.)
Appears in 1 contract
Samples: Counseling Service Agreement
Right to Receive Confidential Communications by Alternative Means and at Alternative Locations. You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For example, you may not want a family member sent to know that you are seeing us. On the location of your request, we will send your communications to another addresschoosing.)
Appears in 1 contract
Samples: Client Services Agreement