PSYCHOLOGICAL SERVICES AGREEMENT & CONSENT for PSYCHOLOGICAL SERVICESPsychological Services Agreement • May 5th, 2020
Contract Type FiledMay 5th, 2020Welcome to the Psychological Services Center (PSC) at Bowling Green State University. This document contains important information about the PSC’s professional services and business policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law that provides privacy protections and client 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 the PSC provide you with a Notice of Privacy Practices for use and disclosure of PHI for treatment, payment and health care operations. The Notice, which must by law be given to you at your first session at the PSC, explains how the PSC complies with HIPAA in its maintenance and disclosure of your personal health information. The law requires that the PSC obtain your signature acknowledging that you have been provided with this information at the end of thi