Common Contracts
1 similar Consent and Agreement for Treatment contracts
Consent and Agreement for Treatment Consent to Collect, Create, Use, Maintain and Disclose Your Health InformationConsent and Agreement for Treatment • November 24th, 2014
When we examine, diagnose, treat, or refer you we will be collecting what the law calls Protected Health Information (PHI) about you. This information may include your health records, health history, symptoms, examination and test results, diagnosis, treatment, treatment plans, and billing and health insurance information. We need to use this information to decide on what treatment is best for you and to provide treatment to you. We may also share this information with others who provide treatment to you or need it to arrange payment for your treatment, or for other business (such as supervision) or required government functions (such as reporting abuse).
