Common Contracts
1 similar Client-Therapist Service Agreement contracts
Suzanne Pratt, LCSW, PC (801) 484-8838Client-Therapist Service Agreement • January 16th, 2019
This agreement contains important information about my professional services and business policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a new federal law that provides new privacy protections and new patient rights with regard to the use and disclosures of your Protected Health Information (PHI) used for the purpose of treatment, payment, and health care operations. The Notice of Policies and Practices to Protect the Privacy of Your Health Information (NOTICE), which accompanies this agreement and is available in the waiting room, explains HIPAA and its application to our personal health information in greater detail. The law requires that I obtain your signature acknowledging that I have provided you with this information at the end of this session. Although the NOTICE is long and sometimes complex, it is very important that you read it carefully before our next session. We can discuss any questions you have about
