Common Contracts
1 similar Office Policies & General Information Agreement for Psychotherapy Services contracts
Cindy M. Kim, MSW, LICSWOffice Policies & General Information Agreement for Psychotherapy Services • September 2nd, 2020
This document 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 relatively new privacy protections and patient rights with regard to the use and disclosure of your protected health information used for the purposes of treatment, payment, and health care operations. In compliance with this law, I am providing you with a more detailed HIPAA Notice of Privacy Practices, which explains this in much greater detail. It is very important that you read these documents carefully. We can, and should, discuss any questions you have about this agreement and/or the attached HIPAA Notice of Privacy Practices at any time. After reviewing this information, please sign this form, which constitutes an agreement between us. You may revoke this agreement in writing at any time.
