Common Contracts
2 similar Psychotherapist-Client Services Agreement contracts
PSYCHOTHERAPIST-CLIENT SERVICES AGREEMENT AND OFFICE POLICIESPsychotherapist-Client Services Agreement • March 20th, 2023
Welcome to my practice. This document (the Agreement) contains important information about my professional services and business policies that is additional to that detailed in the Notice of Privacy Practices. 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 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 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 HIPAA and its application to your 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 these
PSYCHOTHERAPIST-CLIENT SERVICES AGREEMENT AND OFFICE POLICIESPsychotherapist-Client Services Agreement • August 20th, 2021
Welcome to my practice. This document (the Agreement) contains important information about my professional services and business policies that is additional to that detailed in the Notice of Privacy Practices. 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 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 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 HIPAA and its application to your 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 these
