Common Contracts
1 similar Psychotherapist-Patient Agreement contracts
PSYCHOTHERAPIST-PATIENT AGREEMENTPsychotherapist-Patient Agreement • September 22nd, 2008
Welcome to my practice. 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 federal law that provides privacy protections and patient rights with regard to the use and disclosure of Protected Health Information (PHI) used for the purpose of treatment, payment, and health care operations. You may revoke this Agreement in writing at any time. That revocation will be binding on me unless I have taken action in reliance on it; if there are obligations imposed on me by your health insurer in order to process or substantiate claims made under your policy; or if you have not satisfied any financial obligations you have incurred. Please read the Agreement carefully and jot down any questions that you might have so that we can discuss them at our next meeting.
