Common Contracts
1 similar Provider-Client Services Agreement contracts
Provider-Client Services AgreementProvider-Client Services Agreement • January 2nd, 2018
This document (the Agreement) contains important information about our professional services and business policies, including potential risks and benefits of therapy, appointment policies, fee schedule and payment policies, how/when to contact us, confidentiality and its limits, and policy regarding psychotherapy with a minor. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law that provides privacy protections and patient rights regarding the use and disclosure of your Protected Health Information (PHI) used for treatment, payment, and health care operations. HIPAA requires that we 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, an abbreviated version of which is included within this Agreement, explains HIPAA and its application to your personal health information in detail. An expanded version of the Notice is a
