Common Contracts
1 similar Therapist-Client Services Agreement contracts
THERAPIST-CLIENT SERVICES AGREEMENTTherapist-Client Services Agreement • August 20th, 2021
This Agreement is intended to provide (herein "Client") with important information regarding the practices, policies and procedures of Kelley Butler, LCSSW #19697 (herein "Therapist"), and to clarify the terms of the professional therapeutic relationship between Therapist, Client, and the Financial Sponsor. Any questions or concerns regarding the contents of this Agreement should be discussed with Therapist prior to signing. This agreement also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law that provides new privacy protections 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. HIPAA 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 HI
