Common Contracts
1 similar Signatures and Agreement contracts
ContractSignatures and Agreement • November 9th, 2014
Welcome to my practice. This document (the Agreement) contains important information about my professional services and business policies. This document also contains summary information about the Health Insurance Portability and Accountability Act (HIPPA), a federal law that provides privacy protections and 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. HIPPA requires that I provide you with a Notice of Privacy Practices (the Notice) for use as well as disclosure of PHI for treatment, payment, and health care operations. The Notice, which is attached to this Agreement, explains HIPPA 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 documents are long and sometimes complex, I request that you re
