Common Contracts
3 similar Hipaa Client Services Agreement contracts
HIPAA Client Services AgreementHipaa Client Services Agreement • May 22nd, 2017
This document contains important information about my professional policies regarding privacy protection, use, and disclosure of your Protected Health Information (PHI). These policies are in accord with the Health Insurance Portability and Accountability Act (HIPAA). Under HIPAA, I am required to provide you with this information and obtain your signature acknowledging that I have given you this information. By signing your Treatment Policies form, you acknowledge having received this information. I am happy to provide additional copies of this document to you at your request.
HIPAA Client Services AgreementHipaa Client Services Agreement • May 22nd, 2017
This document contains important information about my professional policies regarding privacy protection, use, and disclosure of your Protected Health Information (PHI). These policies are in accord with the Health Insurance Portability and Accountability Act (HIPAA). Under HIPAA, I am required to provide you with this information and obtain your signature acknowledging that I have given you this information. By signing your Treatment Policies form, you acknowledge having received this information. I am happy to provide additional copies of this document to you at your request.
HIPPA Client Services AgreementHipaa Client Services Agreement • April 18th, 2016
This document contains important information about my professional policies regarding privacy protection, use, and disclosure of your Protected Health Information (PHI). These policies are in accord with the Health Insurance Portability and Accountability Act (HIPAA). Under HIPAA, I am required to provide you with this information and obtain your signature acknowledging that I have given you this information. By signing your Treatment Policies form, you acknowledge having received this information. I am happy to provide additional copies of this document to you at your request.
