Inner Connections, LLCTreatment Agreement • October 23rd, 2020
Contract Type FiledOctober 23rd, 2020This document contains information about the services and policies of Inner Connections, LLC. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law that provides privacy protections and new patient rights regarding the use and disclosure of Protected Health Information (PHI) used for treatment, payment, and health care operations. Please read and initial each section and sign the signature page at the end. Before you sign the signature page at the end of this document, we can discuss any questions you have about the policies and procedures described herein. This document also represents an agreement between you and your therapist. You may revoke this Agreement in writing at any time.